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DataCap Quality Analyst - Medical Claims

00068735385

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 – $17 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.


What we offer

  • The chance to work with impact. Here, you’re empowered to bring your biggest thinking to help our company and clients improve everyday life.
  • Ownership over your career. Stay at the top of your game through our award-winning learning and development ecosystem. And when your ambitions change or we offer new opportunities, we help you pivot by providing reskilling, on-the-job learning and guidance to find new roles that might be a better fit.
  • The opportunity to thrive on a high caliber team with heart. We celebrate each other’s experiences and perspectives and promote a sense of belonging through our affinity groups and diversity and inclusion initiatives.
  • A comprehensive total rewards package, including a competitive salary and a pension plan with matching contributions.
  • Flexible health and financial benefits to support you and your eligible dependents—from day one.
  • True work-life balance. Be at your best through paid time off, flexible work arrangements, volunteering opportunities, social events, and so much more.  

About us
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, building the bridge between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization’s unique context into technology systems that amplify human potential, realize tangible returns and keep global enterprises ahead in a fast-changing world. See how at www.cognizant.com or @cognizant.

Other employment-related information
Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, provincial or local laws.

If you have a disability that requires reasonable accommodation to search for a job opening or submit an application, please email [email protected] with your request and contact information.

Language requirements vary depending on roles, but we ask that all candidates have basic English proficiency for company-wide communications purposes. For roles based in Quebec, professional English proficiency is required, as you’ll deliver services to and collaborate with stakeholders outside the province who may not speak French.

Your path to Cognizant

Wondering what to expect after you apply? Here’s a peek at our recruitment process—and keep in mind that not all candidates advance through every step and the process may vary depending on your role and location.

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Step 1: Application

Find an open role that aligns with your skills and career goals and show us why you’re the person for the job. Consider joining our Talent Community if you don’t find the right opportunity.

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Step 2: Recruiter call

If one of our recruiters sees a fit, they’ll set up a short introductory call to learn more about you and how your experiences and skills align with the role.

Step 3: Interview(s)

If you and our team would like to continue the process, you’ll meet with one of our hiring managers. Some roles may also require technical assessments and/or client interviews.

Step 4: Final decision

Our hiring team will then review each candidates’ potential to succeed in the role. This process may take some time because we want to get it right—but you can count on us to keep you updated.

Benefits that help you thrive and grow

Our teams achieve incredible things when they feel fully supported. That’s why our benefits program is built around the diverse needs of our people—so they can enjoy a fulfilling, balanced and healthy life.

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Financial wellbeing

Financial wellbeing

We regularly review market data to ensure compensation is competitive and reflects the value you bring. Your benefits extend beyond pay and may include retirement plans, financial education, discount programs, etc.

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Physical and mental wellbeing

Physical and mental wellbeing

We empower you to prioritize your wellbeing through paid time off, flexible working where possible, healthcare plans, counselling, our Mental Health Allyship program and more. 

Your Career, Your Way
Your career, your way

Your career, your way

With 90% of our associates building skills through GenAI training, job shadowing, industry certifications and more, you have everything you need to build a full career.

Professionals
Real-world impact

Real-world impact

Think about the biggest brands you rely on. Chances are, they rely on us to help strengthen their business. Here, you’ll turn bold ideas into solutions that improve lives everywhere.

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