Job Summary
This role involves providing specialized expertise in claims adjudication within the healthcare domain. The candidate will work from the office during night shifts ensuring accurate and efficient claims processing. The position requires a minimum of 2 years and a maximum of 4 years of relevant experience with a focus on delivering high-quality outcomes.
Responsibilities
- Analyze and process healthcare claims with precision ensuring compliance with adjudication guidelines and policies.
- Collaborate with internal teams to resolve discrepancies and ensure seamless claims adjudication workflows.
- Monitor claims data for accuracy and identify patterns or anomalies that may require further investigation.
- Utilize technical expertise in claims adjudication to optimize processing times and reduce errors.
- Provide detailed documentation and reports on adjudicated claims for auditing and review purposes.
- Ensure adherence to regulatory requirements and company standards in all claims processing activities.
- Communicate effectively with stakeholders to address queries and provide clarifications regarding claims adjudication.
- Stay updated on industry trends and changes in healthcare claims policies to maintain expertise in the domain.
- Support the implementation of process improvements to enhance efficiency and accuracy in claims adjudication.
- Participate in training sessions and knowledge-sharing initiatives to strengthen team capabilities.
- Leverage domain skills in commercial claims payer systems and claims management to deliver impactful results.
- Contribute to the companys mission by ensuring timely and accurate processing of claims positively impacting customer satisfaction.
- Maintain confidentiality and integrity in handling sensitive healthcare claims data. Qualifications
- Demonstrate proficiency in claims adjudication processes and possess hands-on experience in healthcare claims systems.
- Exhibit strong analytical skills to identify and resolve issues in claims processing efficiently.
- Showcase familiarity with commercial claims payer systems and claims management as a nice-to-have domain expertise.
- Display excellent communication skills to interact effectively with stakeholders and team members.
- Possess a detail-oriented mindset to ensure accuracy and compliance in all adjudication tasks.
- Show adaptability to work in night shifts and deliver consistent performance in a dynamic environment.
- Highlight a commitment to continuous learning and staying updated on industry standards and best practices.
Certifications Required
Certified Professional Coder (CPC) Certified Claims Specialist (CCS)
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。
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。
