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
Quality Audit
Ensures agent compliance and adherence to client procedures / policy by reviewing agent activity within the defined quality systems
Root Cause Analysis
- Conducts weekly RCA of errors and assists in creating a weekly deck for review with operations, training, and quality team
- Assess agent performance through audit monitoring as well as 1-2-1 investigatory sessions to identify error trends and performance opportunities
- Works closely with Quality Team Lead and Manager to aggregate, prioritize, and report on the top issues impacting the program
- Contributes error analysis and insights for the preparation of the Weekly Quality reports and decks
Process Improvements
- Develop and maintain inventory of improvement ideas focused on error reduction and improvement of process health and performance
- Quality Monitoring and Coaching
- Provides analysis and recommendations for process improvement, productivity, accuracy & turnaround time
- Calibration / Global Alignment
- Attend quality calibrations and syncs to maintain alignment on process/policy understanding and application
- Perform calibration audits in sync with program SMEs and TLs to ensure audit accuracy and alignment
Communication:
- Update trackers and required applications & tools and keep management informed of emerging issues/risks
- Creation of daily, weekly, monthly reports monitoring associate and program performance to be shared with leadership
Coaching & Feedback
- Mentors / Coaches agents in relation to qualitative performance enhancement
Provides regular 1-2-1 feedback sessions with agents in correlation to quality performance and opportunities
Program Governance
- Works alongside the training team to provide insights into error trends, process gaps and performance adherence to develop assessments and knowledge checks for reviewer workflow certifications
- Monitor and adhere to policy and process change guidelines and expectations. Including providing feedback and clarification on identified changes.
- Conducts quarterly reviews of SOPs to ensure they are aligned to the current processes and policy
- Develop and maintain process documentation which outlines the quality program and approach
Personal Excellence
- Meet/Exceed targets set within the key activities
- Be an exceptional team player when it comes to knowledge sharing, training, people development and reporting
- Participate in special projects/manage individual projects, and act as a guide to ensure the project meets SLA’s
- Strives to identify new opportunities to provide a better reviewer and end-user experience
- Evaluates processes and make recommendations for improvement
- Contribute to and participate proactively in knowledge sharing sessions
- Participate and contribute to organizational activities
Desired Skills & Experience
- At least a High School Diploma or equivalent is required
- Proven expertise in all workflows
- Minimum 18 months’ experience in full-time Operations role
- Exceptional English communication skills
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 $15 – $117 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。