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PE-Claims HC

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Job Summary

Join our dynamic team as a PE-Claims HC specialist where you will play a crucial role in processing and adjudicating claims with precision and efficiency. This hybrid role offers the opportunity to work with Medicare and Medicaid claims ensuring compliance and accuracy. With a focus on night shifts you will contribute to our mission of delivering exceptional healthcare services.


Responsibilities

  • Process and adjudicate claims with a focus on accuracy and compliance ensuring timely resolution.
  • Collaborate with team members to review and analyze Medicare and Medicaid claims identifying discrepancies and resolving issues.
  • Utilize technical skills in claims adjudication to streamline processes and enhance efficiency.
  • Maintain up-to-date knowledge of industry regulations and standards to ensure compliance in all claims processing activities.
  • Communicate effectively with internal and external stakeholders to facilitate smooth claims processing and resolution.
  • Monitor and report on claims processing metrics identifying areas for improvement and implementing solutions.
  • Provide support and guidance to team members fostering a collaborative and productive work environment.
  • Participate in training sessions and workshops to enhance skills and stay informed about industry trends.
  • Contribute to the development and implementation of best practices for claims processing and adjudication.
  • Ensure all claims are processed in accordance with company policies and procedures maintaining high standards of quality.
  • Assist in the preparation of reports and documentation related to claims processing activities.
  • Engage in continuous learning and development to enhance technical and domain expertise.
  • Support the companys mission by delivering exceptional service and contributing to the overall success of the healthcare claims department.

    • Qualifications

  • Demonstrate proficiency in claims adjudication with a strong understanding of Medicare and Medicaid claims.
  • Possess excellent analytical and problem-solving skills to identify and resolve claims discrepancies.
  • Exhibit strong communication skills to effectively interact with team members and stakeholders.
  • Show a commitment to continuous learning and professional development in the healthcare claims domain.
  • Display attention to detail and accuracy in all aspects of claims processing.
  • Have the ability to work independently and collaboratively in a hybrid work model.
  • Be adaptable to night shift work ensuring consistent performance and productivity.

    • Certifications Required

    N / A

     

     

    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 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 is one of the world's leading professional services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build, and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant (a member of the NASDAQ-100 and one of Forbes World’s Best Employers 2024) is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com.

    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.

    While our system allows applications in all languages, job required language(s) and proficiency level(s) vary. However, basic English proficiency is required for Company-wide communications purposes. Further, for roles located in Quebec, professional English proficiency is required to communicate with our global clients. 

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