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SPE-Enrollment & Billing

00071004881



Job Summary

Serve as a specialist in enrollment and billing operations within healthcare products applying expertise in eligibility and benefit verification demographic data entry and claim or charge entry. Contribute to accurate member onboarding precise billing and smooth revenue workflows in a work from office day shift model ensuring compliance and high quality service delivery.


Responsibilities

  • Manage end to end enrollment processing within healthcare products to ensure accurate and timely member onboarding that supports reliable coverage activation and billing integrity.
  • Execute detailed eligibility and benefit verification activities to confirm member coverage parameters and minimize claim denials while strengthening trust in healthcare plan accuracy.
  • Perform precise demographic data entry for member and subscriber records to maintain high quality datasets that drive accurate billing communications and regulatory reporting.
  • Handle claim and charge entry tasks with strong attention to detail to support clean claim submissions and efficient reimbursement cycles for healthcare services.
  • Monitor daily work queues for enrollment and billing transactions to prioritize tasks effectively and support consistent throughput in a work from office day schedule.
  • Collaborate with operations and billing colleagues to resolve data inconsistencies or missing information that may impact eligibility verification and claim accuracy.
  • Use healthcare product systems and related applications to research member records and update enrollment details in alignment with policy guidelines and compliance controls.
  • Investigate basic discrepancies in premium calculations or claim charge data and escalate complex issues through defined channels to safeguard financial accuracy.
  • Apply knowledge of eligibility and benefit rules to identify potential errors in member setup and proactively correct records to enhance downstream claim processing.
  • Maintain comprehensive documentation of enrollment and billing actions taken within case management tools to support audit readiness and operational transparency.
  • Adhere to organizational standards for data privacy and security while handling sensitive member information in an office based environment without travel requirements.
  • Contribute to continuous improvement initiatives by sharing observations on recurring data or process issues that affect enrollment quality and claim workflows.
  • Support cross functional collaboration by providing clear operational insights to teams focused on customer service and provider relations so business outcomes and societal impact are enhanced.

  • Qualifications

  • Possess hands on experience working with healthcare products and operational systems that manage member enrollment and billing transactions in a structured environment.
  • Demonstrate practical knowledge in eligibility and benefit verification including interpreting coverage details and applying rules to real world member scenarios.
  • Show proven capability in demographic data entry with strong typing accuracy and data validation habits to support clean member record maintenance.
  • Bring direct experience in claim and charge entry processes including coding basic service information and validating figures for processing consistency.
  • Hold one to three years of exposure to healthcare domain operations with focus on enrollment billing eligibility verification and transaction based workflows.
  • Exhibit familiarity with regulatory and compliance expectations related to healthcare data handling and member information management.
  • Display strong analytical and problem solving skills to identify root causes of data or process variances and implement practical corrections.
  • Demonstrate effective communication and collaboration abilities suited to an office based day shift environment that relies on teamwork and clear documentation.

  • 关于高知特 (Cognizant)
    高知特(Cognizant)(纳斯达克代码:CTSH)作为一家AI Builder和相关技术服务提供商,致力于通过打造全栈AI解决方案,帮助企业将人工智能投资转化为实际价值。公司凭借深厚的行业经验、流程优化和工程技术专长,将企业独特的业务场景融入科技系统,赋能组织释放人才潜能,推动切实成果,并帮助全球企业在瞬息万变的环境中保持领先。如需了解更多详情,敬请访问 cognizant.ai 或关注@cognizant。

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