Job Summary
Serve as a subject matter expert in learning and development for claims adjudication and health privacy regulation within payer and provider operations designing and delivering targeted hybrid learning experiences for night shift teams that enhance accuracy compliance and service quality while supporting the company mission to improve healthcare outcomes.
Responsibilities
- Design and deliver structured learning programs focused on claims adjudication workflows that help operational teams improve processing accuracy and cycle times in payer and provider environments.
- Develop clear learning content on health privacy rules and related industry guidelines that supports consistent compliance in daily claims handling activities.
- Conduct detailed training needs analysis with operations stakeholders to identify skill gaps in claims adjudication and translate them into focused learning objectives.
- Create engaging digital and classroom ready learning assets tailored for hybrid work conditions so that night shift learners can access knowledge effectively.
- Coordinate and facilitate interactive virtual sessions for night shift staff that encourage practical application of provider and payer concepts in real case scenarios.
- Evaluate learner performance through assessments and scenario based exercises that reveal strengths and development areas in claims adjudication and health privacy understanding.
- Track and analyze training effectiveness metrics such as error reduction rework rates and first pass resolution to demonstrate the impact of learning programs on business outcomes.
- Partner with operations quality and compliance teams to keep learning content updated with current payer policies provider contracts and regulatory expectations.
- Maintain detailed documentation of learning materials attendance records and evaluation results to support internal and external audits.
- Provide targeted coaching and floor support during early adoption phases after training so that learners can confidently apply new skills on live claims.
- Align learning plans with career development pathways for operations staff to support long term capability building in claims and health privacy disciplines.
- Collaborate with knowledge management teams to convert frequently asked questions and recurring issues into concise learning resources for continuous reference.
- Contribute to a culture of continuous improvement by gathering learner feedback and using it to refine learning design methods and delivery practices.
Qualifications
- Bring practical experience working in claims adjudication processes with clear understanding of end to end claim life cycle and common exception scenarios.
- Demonstrate applied knowledge of health privacy administrative requirements and their implications on claim data handling and communication.
- Offer hands on exposure to payer business rules benefit designs and authorization requirements that influence adjudication decisions.
- Apply working knowledge of provider contracts reimbursement methodologies and coding standards as they relate to claim evaluation.
- Utilize prior experience supporting operations or training functions for night shift or hybrid teams with sensitivity to schedule and engagement challenges.
- Use strong communication and facilitation skills to explain complex payer and provider concepts in simple terms for diverse learner groups.
- Employ basic data analysis skills to interpret performance reports and align learning interventions with measurable business needs.
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。
补充雇佣信息
薪酬信息截至本职位发布之日为准。Cognizant 保留在适用法律允许的范围内随时修改该信息的权利。
申请人可能需要通过现场面试或视频会议的方式参加面试。此外，候选人在每次面试时可能需要出示其当前所在州或政府签发的有效身份证件。
Cognizant 是一家提供平等就业机会的雇主。在招聘过程中，您的申请和候选资格不会因种族、肤色、性别、宗教、信仰、性取向、性别认同、国籍、残疾、遗传信息、怀孕、退伍军人身份或任何其他受联邦、州或地方法律保护的特征而受到影响。
