Job Summary
Serve as a specialist in enrollment and billing operations for payer clients ensuring accurate member data management and compliant premium processing within a hybrid night shift model. Apply strong MS Office skills and HIPAA knowledge to maintain data integrity support issue resolution and contribute to reliable healthcare coverage for members and providers.
Responsibilities
- Manage end to end enrollment processing activities to ensure timely and accurate setup of member records for payer clients in alignment with plan rules and regulatory expectations.
- Coordinate billing cycles for premiums and adjustments to maintain precise financial records that support stable revenue flow and reliable coverage for members.
- Validate member eligibility demographic details and product selections using MS Office tools to reduce errors and avoid downstream claim processing issues.
- Analyze enrollment and billing discrepancies by comparing source data system records and payer reports to identify root causes and propose corrective actions.
- Document all enrollment and billing actions in standard templates using spreadsheets and word processing tools to create auditable transaction histories.
- Apply HIPAA privacy concepts during daily handling of protected health information to safeguard member data and support regulatory compliance.
- Respond to internal queries on enrollment status premium amounts and account changes with clear and timely explanations that enable informed decisions.
- Collaborate with cross functional operations and quality teams to refine enrollment and billing workflows that enhance accuracy speed and member satisfaction.
- Track work items and service level targets to ensure all enrollment and billing tasks are completed within agreed timelines and quality thresholds.
- Support testing of minor system changes or configuration updates by executing defined scenarios and documenting observed issues for technical teams.
- Prepare recurring operational reports using spreadsheets to summarize volumes errors and trends that inform process improvements.
- Assist in creating and updating standard operating procedures for enrollment and billing tasks so that knowledge is captured and consistently applied.
- Adapt to a hybrid night shift work environment while maintaining productivity clear communication and adherence to all security guidelines.
Qualifications
- Understand payer domain concepts such as member eligibility plan benefits premium rules and coordination of benefits sufficient to interpret enrollment and billing scenarios accurately.
- Use MS Office applications with strong proficiency including spreadsheets for data analysis word processors for documentation and presentations for simple status updates.
- Apply HIPAA knowledge in practical situations by recognizing sensitive data following access protocols and supporting secure information exchange.
- Demonstrate at least one year of experience in enrollment billing or similar payer operations functions with attention to detail and error prevention.
- Communicate clearly in both written and verbal form with operations teams supervisors and where applicable client contacts to resolve issues efficiently.
- Manage time effectively during night shifts in a hybrid work setup by organizing tasks prioritizing queues and meeting daily production and quality goals.
- Show willingness to learn new payer products system features and updated guidelines to keep enrollment and billing practices current and effective.
About Cognizant:
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap 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, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.
Additional employment information
Compensation 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.
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.
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.
