Job Summary
We are seeking a detail-oriented and motivated individual for the role of PE-Claims HC. The candidate will be responsible for processing Medicare and Medicaid claims with precision and efficiency. Proficiency in MS Excel and claims adjudication is essential. This is a night shift work-from-office role requiring strong English communication skills.
Responsibilities
- Process Medicare and Medicaid claims with a high level of accuracy and adherence to regulatory guidelines.
- Utilize MS Excel to analyze organize and validate claims data for efficient processing.
- Ensure timely adjudication of claims while maintaining compliance with company and industry standards.
- Identify discrepancies in claims and take corrective actions to resolve them effectively.
- Collaborate with internal teams to ensure seamless claims processing and issue resolution.
- Maintain up-to-date knowledge of Medicare and Medicaid policies and procedures to ensure compliance.
- Provide detailed documentation of claims adjudication processes and outcomes for audit purposes.
- Communicate effectively with stakeholders to clarify claim-related queries and provide resolutions.
- Monitor claims workflow to ensure deadlines are consistently met without compromising quality.
- Support the team in identifying process improvement opportunities to enhance operational efficiency.
- Adhere to data privacy and confidentiality standards while handling sensitive claim information.
- Participate in training sessions to stay updated on industry trends and software tools.
- Contribute to the companys mission of delivering exceptional service and improving healthcare outcomes.
Qualifications
- Possess strong proficiency in MS Excel including functions such as data analysis and reporting.
- Demonstrate expertise in claims adjudication processes ensuring accuracy and compliance.
- Have a solid understanding of Medicare and Medicaid claims including regulatory requirements.
- Exhibit excellent English communication skills both written and verbal for effective collaboration.
- Show attention to detail and problem-solving skills to handle complex claim scenarios.
- Display the ability to work efficiently in a night shift work-from-office environment.
Certifications Required
Certified Professional Biller (CPB) or equivalent certification in claims processing.
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。
