About the Role
As a Complex Claims Representative, you will play a vital role in supporting our clients by investigating, evaluating, and resolving complex claims involving auto insurance coverage, litigation, and workers' compensation. You will be part of Cognizant's dedicated back-office team, collaborating with internal stakeholders to uphold quality and compliance standards in claims administration.
In this role, you will:
- Identify and manage auto claims, litigation, workers' compensation claims, and health insurance verifications.
- Investigate specific reasons for underpayments, denials, and payment delays and take appropriate action.
- Track and trend claim denials and underpayments to identify opportunities for payer, process, or technology improvements.
- Maintain a thorough understanding of federal and state regulations, as well as payer-specific requirements.
- Partner with management to identify, trend, and address root causes of claims issues.
- Make recommendations for additions, revisions, or deletions to work queues and claim edits to improve efficiency.
- Identify patterns and escalate to management with sufficient detail to support root cause resolution.
- Document all actions and updates accurately in account records, including contact names, addresses, and pertinent information.
- Contribute to team success by assisting with other responsibilities as assigned.
Work Schedule: Monday through Friday – shifts start between 7:00 AM and 9:00 AM CST (9-hour shifts).
This is a remote position open to qualified applicants across the United States. Candidates must be available to work CST/EST hours. We prioritize flexibility and support your wellbeing through a variety of programs designed to promote a healthy work-life balance.
Please note: Working arrangements are accurate as of the posting date and may evolve based on project or client needs. If changes occur, we will communicate expectations clearly.
What you need to have to be considered:
- High school diploma or GED equivalent
- Exceptional problem-solving and critical thinking skills; must meet quality and productivity standards
- Strong verbal and written communication skills
These will help you stand out:
- Working knowledge of auto coverage, litigation, and workers' compensation claims
- Knowledge of state/federal billing guidelines, reimbursement methodologies, and payer policies
- Understanding of the RCM cycle, auto coverages, and Medicare, Medicaid, Managed Care, and Commercial payer processes
- Experience tracking and trending claim denials and underpayments
- Familiarity with payer-specific requirements and billing compliance
- Background in legal, litigation, or compliance-related claims handling
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.
We are excited to meet people who share our mission and can make an impact in a variety of ways. Do not hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.
Hourly Rate and Other Compensation: The hourly rate for this position is between $19.00 – $22.00 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.
Applications will be accepted until June 30th, 2026.
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.
À propos de Cognizant
Cognizant (NASDAQ : CTSH) est un AI Builder et une entreprise de services numériques (ESN) élaborant des solutions complètes d’IA maximisant les investissements pour des résultats concrets. Sa profonde expertise des métiers, des processus et des technologies lui permet d’intégrer dans les systèmes technologiques le contexte unique de chaque organisation de l’ingénierie à la production à l’échelle. Son objectif : améliorer l’efficacité des équipes, créer de la valeur et permettre aux grandes entreprises de rester performantes dans un monde qui évolue rapidement. Pour en savoir plus : cognizant.ai ou @cognizant.
Renseignments suppplémentaires sur l'emploi
Les informations sur la rémunération sont exactes à la date de publication. Cognizant se réserve le droit de modifier ces informations à tout moment, conformément aux lois applicables.
Les exigences linguistiques varient selon les postes, mais nous demandons à tous les candidats d’avoir une connaissance de base de l’anglais afin de faciliter les communications internes à l’échelle de l’entreprise. Pour les postes basés au Québec, une maîtrise de l’anglais est requise puisque vous fournirez des services et collaborerez avec des parties prenantes situées hors de la province, qui ne parlent pas nécessairement le français.
Cognizant est un employeur souscrivant au principe de l’égalité d’accès à l’emploi. Votre candidature et votre dossier ne seront pas examinés en fonction de la race, de la couleur, du sexe, de la religion, des croyances, de l'orientation sexuelle, de l'identité de genre, de l'origine nationale, du handicap, de l'information génétique, de la grossesse, du statut d'ancien combattant ou de toute autre caractéristique protégée telle que décrite par les lois fédérales, provinciales ou locales.
Si vous avez un handicap qui nécessite un aménagement raisonnable pour rechercher une offre d'emploi ou poser une candidature, envoyiez un courriel à [email protected] avec votre demande et vos coordonnées.
