Cognizant is a large IT Consulting Firm that leverages modern technologies to transform a variety of business operations. We are seeking Fully Remote US Based Claims Processors to join our growing team. Claim processors will review claim submissions, verify information, adjudicate or adjust the claim as per claim processing guidelines to ensure appropriate payment or denial as per the business requirements.
Role Responsibilities
- Examine and enter basic claims for appropriateness of care and completeness of information in accordance with accepted coverage guidelines, ensuring all mandated government and state regulations are consistently met
- Process claims for multiple plans with automated and manual differences in benefits, as well as utilizing the system and written documentation to determine the appropriate payment for a specific benefit
- Approve pending or denying payment according to the accepted coverage guidelines
- Follow all team procedures, including HIPAA policies and procedures, and meets team quality, turnaround time and productivity performance standards and goals
- Identify and refer to all claims with potential third party liability (i.e.,. subrogation, COB, MVA, stop loss claims, and potential stop loss files)
- Maintain internal customer relations by interacting with staff regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing information, and updating information to claim file with regard to claims status, questions or claim payments
- Other duties as assigned
- Must be willing to work overtime when the business need require
Desired Skills & Experience
- At least a High School Diploma or equivalent is required
- A minimum of 2-3 years of medical claims processing is required
- Ability to work independently
- Strong attention to detail
- Strong interpersonal, time management and organizational skills
- Good oral/written communication and analytical skills
- Must be able to work in a high performance environment that changes often
- Experience in navigating multiple systems using dual monitors
- Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes, and standard of billing guidelines required.
- FACETS experience (highly preferred)
- Medicaid knowledge (required)
- Keyboard skills of at least 35 WPM + 10-key
- Proficient in Microsoft Office – Excel, Word, and Outlook
- Healthcare claims payer processing experience (required)
- Ability to work in a high pace while maintaining quality and productivity targets
Working Environment Requirement
- Ability to work remotely in a secure environment (Required)
- Must have high-speed internet connection ( Required)
- Must have highs-speed internet modem with ability to connect laptop to wired connection port (Required)
- Must have a workspace and location free from distractions and safety of healthcare data (Required)
Salary and Other Compensation
Applications will be accepted until May 22nd, 2026.
The hourly rate for this position is between $16 – $19 per hour, depending on experience and other qualifications of the successful candidate.
This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant’s applicable plans.
Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
- Medical/Dental/Vision/Life Insurance
- Paid holidays plus Paid Time Off
- 401(k) plan and contributions
- Long-term/Short-term Disability
- Paid Parental Leave
- Employee Stock Purchase Plan
Disclaimer: The hourly rate, other compensation, and benefits 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.
Cognizant will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.
コグニザントのコミュニティ：
私たちは、互いを尊重し支え合う優秀な人材の集まりです。社員一人ひとりが成長し、力を発揮できるよう、エネルギッシュで協力的かつインクルーシブな職場環境を大切にしています。
- コグニザントは、世界中に30万人以上のアソシエイトを擁するグローバルコミュニティです。
- 私たちは、より良い方法を夢見るだけでなく、それを実現します。
- 人、クライアント、企業、地域社会、そして環境に対して、常に「正しいこと」を行うことで責任を果たします。
- あなたにとって最適なキャリアパスを築くことができる、革新的な環境を提供します。
私たちについて：
コグニザント（NASDAQ: CTSH）は、AI builderおよびテクノロジーサービスプロバイダとして、AI投資を企業価値へとつなげるフルスタックのAIソリューションを提供しています。業界、業務プロセス、エンジニアリングに関する深い専門性を強みに、各企業固有のコンテキストをテクノロジーシステムに組み込み、人の力を最大限に引き出すとともに、具体的な成果の創出と、急速に変化する世界におけるグローバル企業の競争力維持を支援します。詳しくは、当社ウェブサイト www.cognizant.com をご覧ください。
コグニザントは機会均等を重視する雇用主です。応募者および候補者は、人種、肌の色、性別、宗教、信条、性的指向、性自認、国籍、障がい、遺伝情報、妊娠、退役軍人の地位、または連邦、州、地方の法律で保護されているその他の特性に基づいて差別されることはありません。
免責事項：
応募者は、対面またはビデオ会議による面接への参加を求められる場合があります。また、各面接の際に、現住所または政府発行の身分証明書の提示が必要となる場合があります。