We are Looking for a strong US Healthcare Claims SME who can also play the Business Analyst role
- Primary requirement: Deep Claims Adjudication expertise with 8–12+ years of relevant US Healthcare experience.
- Understand and challenge complex Claims business requirements
- Translate requirements into strong User Stories & Acceptance Criteria
- Identify business-rule gaps, dependencies and exception scenarios
- Guide Development & Testing teams throughout the sprint
- Understand end-to-end adjudication including Benefits, Pricing, Provider, COB, Member liability, Denials/Pends, Adjustments and Reprocessing
Preferred: Agile/Scrum exposure, SQL knowledge and experience with Facets or a similar payer core administration platform.
About Cognizant:
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization’s unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.
Additional employment information
Compensation information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.
Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.
