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.
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.