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SPE-Enrollment & Billing

00069356473



Job Summary

Serve as a specialist in enrollment and billing for a global payer organization ensuring accurate member data maintenance and compliant billing operations in a hybrid night shift role. Apply strong MS Office proficiency and working knowledge of HIPAA standards to support timely processing issue resolution and continuous improvement of payer enrollment and billing workflows.


Responsibilities

  • Manage end to end member enrollment activities by accurately capturing validating and updating payer data within internal systems to support timely coverage activation and billing accuracy.
  • Process billing transactions for premiums adjustments and reconciliations with close attention to detail to reduce financial discrepancies and support reliable revenue cycles.
  • Analyze enrollment and billing input files reports and transaction logs using MS Office tools to identify data issues trends and reconciliation gaps that require corrective actions.
  • Coordinate with internal operations client service and technology teams through clear and structured communication to resolve enrollment and billing queries within agreed timelines.
  • Maintain strict adherence to HIPAA requirements by handling protected health information with confidentiality and following documented privacy and security controls.
  • Create and maintain structured logs trackers and status reports in spreadsheets to monitor work volumes turnaround times and error rates for ongoing operational transparency.
  • Review enrollment forms eligibility feeds and billing records against payer rules to validate completeness accuracy and compliance with contractual and regulatory guidelines.
  • Investigate member or client reported discrepancies in enrollment status or billing amounts document root causes and execute corrections to minimize rework and dissatisfaction.
  • Utilize productivity and quality metrics to prioritize daily workload manage peak volumes in the night shift and consistently meet or exceed service commitments.
  • Document standard operating procedures exception handling steps and job aids in clear and structured formats to support team consistency and future training needs.
  • Collaborate with quality and process excellence teams to suggest enhancements that streamline enrollment and billing workflows and reduce manual data handling effort.
  • Support system testing activities related to enrollment and billing changes by executing predefined test cases validating results and documenting issues for follow up.
  • Adapt to hybrid work expectations by maintaining reliable virtual collaboration secure data handling practices and consistent performance across onsite and remote settings.

  • Qualifications

  • Possess foundational experience in payer operations with exposure to enrollment and billing processes that demonstrates understanding of eligibility premiums and coverage rules.
  • Apply strong working knowledge of MS Office with emphasis on spreadsheets word processing and presentations to prepare reports analyze data and communicate findings clearly.
  • Demonstrate practical understanding of HIPAA concepts related to privacy security and permissible use of health information to ensure compliant day to day processing.
  • Exhibit effective written and verbal communication skills to interact with cross functional stakeholders and respond to client queries in a clear and professional manner.
  • Show capability to work consistently in a night shift hybrid environment by managing time focus and well being while maintaining productivity and accuracy.
  • Display analytical thinking and problem solving abilities that support investigation of enrollment and billing issues and formulation of fact based corrective actions.
  • Illustrate eagerness to learn payer products benefit structures and system functionalities to grow into more complex enrollment and billing responsibilities over time.

  • 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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