Job Summary
Serve as a subject matter expert in learning and development for claims adjudication and health privacy regulation within payer and provider operations designing and delivering targeted hybrid learning experiences for night shift teams that enhance accuracy compliance and service quality while supporting the company mission to improve healthcare outcomes.
Responsibilities
- Design and deliver structured learning programs focused on claims adjudication workflows that help operational teams improve processing accuracy and cycle times in payer and provider environments.
- Develop clear learning content on health privacy rules and related industry guidelines that supports consistent compliance in daily claims handling activities.
- Conduct detailed training needs analysis with operations stakeholders to identify skill gaps in claims adjudication and translate them into focused learning objectives.
- Create engaging digital and classroom ready learning assets tailored for hybrid work conditions so that night shift learners can access knowledge effectively.
- Coordinate and facilitate interactive virtual sessions for night shift staff that encourage practical application of provider and payer concepts in real case scenarios.
- Evaluate learner performance through assessments and scenario based exercises that reveal strengths and development areas in claims adjudication and health privacy understanding.
- Track and analyze training effectiveness metrics such as error reduction rework rates and first pass resolution to demonstrate the impact of learning programs on business outcomes.
- Partner with operations quality and compliance teams to keep learning content updated with current payer policies provider contracts and regulatory expectations.
- Maintain detailed documentation of learning materials attendance records and evaluation results to support internal and external audits.
- Provide targeted coaching and floor support during early adoption phases after training so that learners can confidently apply new skills on live claims.
- Align learning plans with career development pathways for operations staff to support long term capability building in claims and health privacy disciplines.
- Collaborate with knowledge management teams to convert frequently asked questions and recurring issues into concise learning resources for continuous reference.
- Contribute to a culture of continuous improvement by gathering learner feedback and using it to refine learning design methods and delivery practices.
Qualifications
- Bring practical experience working in claims adjudication processes with clear understanding of end to end claim life cycle and common exception scenarios.
- Demonstrate applied knowledge of health privacy administrative requirements and their implications on claim data handling and communication.
- Offer hands on exposure to payer business rules benefit designs and authorization requirements that influence adjudication decisions.
- Apply working knowledge of provider contracts reimbursement methodologies and coding standards as they relate to claim evaluation.
- Utilize prior experience supporting operations or training functions for night shift or hybrid teams with sensitivity to schedule and engagement challenges.
- Use strong communication and facilitation skills to explain complex payer and provider concepts in simple terms for diverse learner groups.
- Employ basic data analysis skills to interpret performance reports and align learning interventions with measurable business needs.
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.
