About the Role
As a Complex Claims Representative, you will play a vital role in supporting our clients by investigating, evaluating, and resolving complex claims involving auto insurance coverage, litigation, and workers' compensation. You will be part of Cognizant's dedicated back-office team, collaborating with internal stakeholders to uphold quality and compliance standards in claims administration.
In this role, you will:
- Identify and manage auto claims, litigation, workers' compensation claims, and health insurance verifications.
- Investigate specific reasons for underpayments, denials, and payment delays and take appropriate action.
- Track and trend claim denials and underpayments to identify opportunities for payer, process, or technology improvements.
- Maintain a thorough understanding of federal and state regulations, as well as payer-specific requirements.
- Partner with management to identify, trend, and address root causes of claims issues.
- Make recommendations for additions, revisions, or deletions to work queues and claim edits to improve efficiency.
- Identify patterns and escalate to management with sufficient detail to support root cause resolution.
- Document all actions and updates accurately in account records, including contact names, addresses, and pertinent information.
- Contribute to team success by assisting with other responsibilities as assigned.
Work Schedule: Monday through Friday – shifts start between 7:00 AM and 9:00 AM CST (9-hour shifts).
This is a remote position open to qualified applicants across the United States. Candidates must be available to work CST/EST hours. We prioritize flexibility and support your wellbeing through a variety of programs designed to promote a healthy work-life balance.
Please note: Working arrangements are accurate as of the posting date and may evolve based on project or client needs. If changes occur, we will communicate expectations clearly.
What you need to have to be considered:
- High school diploma or GED equivalent
- Exceptional problem-solving and critical thinking skills; must meet quality and productivity standards
- Strong verbal and written communication skills
These will help you stand out:
- Working knowledge of auto coverage, litigation, and workers' compensation claims
- Knowledge of state/federal billing guidelines, reimbursement methodologies, and payer policies
- Understanding of the RCM cycle, auto coverages, and Medicare, Medicaid, Managed Care, and Commercial payer processes
- Experience tracking and trending claim denials and underpayments
- Familiarity with payer-specific requirements and billing compliance
- Background in legal, litigation, or compliance-related claims handling
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.
We are excited to meet people who share our mission and can make an impact in a variety of ways. Do not hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.
Hourly Rate and Other Compensation: The hourly rate for this position is between $19.00 – $22.00 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.
Applications will be accepted until June 30th, 2026.
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.
コグニザントについて
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ーとして、お客様にフルスタックのAIソリューションを構築することで、AI投資と企業価値を結ぶ架け橋となっています。業界、ビジネスプロセス、エンジニアリングに関する当社の深い専門知識を活かし、組織固有のビジネス環境をテクノロジー・システムに組み込みます。これにより、人間の可能性を最大限に引き出し、確かな成果を実現するとともに、急速に変化する世界においてグローバル企業が常に一歩先を行くための支援を行っています。 詳細については、cognizant.ai をご覧ください。
雇用に関する追加情報
本募集に記載されている報酬情報は、掲載日時点で正確なものです。Cognizantは、適用される法令に従い、いつでも本情報を変更する権利を留保します。
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、現在有効な州政府または政府発行の身分証明書の提示を求められる場合があります。
Cognizantは機会均等雇用主です。応募および選考において、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、その他連邦法・州法・地方自治体の法律により保護されるいかなる特性に基づく差別も行いません。
