TL-Enrollment & Billing

Job Summary

This hybrid night shift role for TL Enrollment and Billing focuses on managing complex healthcare product enrollment and billing processes within commercial insurance. The candidate will drive accuracy in member enrollment data premium calculations and billing reconciliation to support compliance and client satisfaction. With eight to ten years of experience the role ensures operational excellence while collaborating across teams using strong English communication skills to improve service o

Responsibilities

• Lead end to end enrollment processing for commercial insurance members in healthcare products ensuring accurate capture of demographic and coverage details to support timely and error free policy activation.
• Oversee billing setup and premium calculation for new and existing commercial insurance accounts ensuring that rating rules product configurations and policy terms are applied correctly for financial integrity.
• Coordinate with operations and configuration teams in a hybrid work model to resolve enrollment and billing discrepancies ensuring that each case is analyzed root causes are documented and resolutions prevent recurrence.
• Manage night shift workflow for enrollment and billing queues by tracking daily volumes allocating work items and monitoring service levels so that turnaround time and quality targets are consistently met.
• Review complex enrollment change events such as adds terms and reinstatements for commercial insurance groups to ensure that coverage changes align with client contracts regulatory norms and member expectations.
• Validate billing files invoices and payment application reports from healthcare product systems ensuring that all charges adjustments and credits reconcile with enrollment data and agreed billing schedules.
• Collaborate with client facing teams to interpret and implement commercial insurance benefit designs contribution structures and eligibility rules so that enrollment and billing configuration in systems reflects contractual commitments.
• Provide detailed data analysis on enrollment and billing trends including error patterns revenue impact and operational bottlenecks to support process improvements and informed business decisions.
• Monitor compliance with internal controls and regulatory guidelines related to healthcare products and commercial insurance enrollment ensuring that documentation audit trails and approvals are complete and accessible.
• Guide team members in handling complex enrollment and billing scenarios by sharing domain knowledge reviewing work output and reinforcing standard operating procedures to uplift overall team performance.
• Drive continuous improvement initiatives across enrollment and billing processes by identifying automation opportunities optimizing workflows and proposing system enhancements that increase efficiency and accuracy.
• Coordinate production support for healthcare product enrollment and billing issues during night shifts by logging incidents prioritizing resolution and validating fixes to protect service continuity.
• Contribute to organizational goals by ensuring that accurate enrollment and billing support timely access to coverage minimize financial leakage and strengthen trust among employers members and partners. Qualifications
• Possess eight to ten years of hands on experience in healthcare product operations focusing on enrollment and billing for commercial insurance accounts with a proven record of meeting quality and service standards.
• Demonstrate deep domain expertise in commercial insurance enrollment processes including group setup member eligibility verification dependent coverage and life event handling for varied client segments.
• Apply strong working knowledge of healthcare product platforms and billing modules to configure plans manage rate tables and troubleshoot data issues affecting invoices and premium statements.
• Utilize advanced analytical and problem solving skills to interpret enrollment and billing data identify root causes of discrepancies and propose pragmatic solutions aligned with business priorities.
• Exhibit excellent English communication skills in reading writing and speaking to document complex cases collaborate with cross functional stakeholders and explain technical findings in clear terms.
• Maintain high attention to detail and process discipline in a hybrid work environment managing night shift responsibilities while adhering to security compliance and governance requirements.
• Show capability to mentor and support peers in enrollment and billing practices by sharing knowledge participating in calibration sessions and promoting consistent adherence to operational standards.

Certifications Required

Preferred certifications include health insurance or healthcare administration certification and any recognized healthcare product or medical billing certification.

À savoir avant de postuler

• Autorisation de travail: Cognizant ne prendra en considération que les candidats à ce poste qui sont légalement autorisés à travailler au Canada sans avoir besoin d'un parrainage de l'employeur, aujourd'hui ou à l'avenir.
• Mesures d’adaptation: Si vous avez un handicap qui nécessite des mesures d’adaptation raisonnable pour effectuer une recherche d’emploi ou poser une candidature, veuillez envoyer un courriel à [email protected] avec votre demande et vos coordonnées.
• L’IA dans notre processus de recrutement: Nous utilisons des outils d'intelligence artificielle (IA) pour trier et évaluer les candidatures efficacement. Notre équipe examine ensuite les candidatures et décide qui passe à l’étape suivante.
• Poste à pourvoir: Sauf indication contraire, ce poste est actuellement vacant et nous cherchons à le pourvoir.
• Exigences linguistiques: Nous demandons à tous les candidats de posséder une connaissance de base de l’anglais afin de faciliter les communications internes. Pour les postes au Québec, la capacité à communiquer efficacement en anglais est requise car vous fournirez des services à et collaborerez avec des parties prenantes anglophones situées hors de la province.
• Inclusion: 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, des renseignements génétiques, de la grossesse, du statut d'ancien combattant ou de toute autre caractéristique protégée par les lois fédérales, provinciales ou locales.

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.