About the role
As a Senior Healthcare Claims Test Lead, you will make an impact by leading testing initiatives for Medicare claims and healthcare payment solutions. You will independently manage testing activities across the project lifecycle, with a strong focus on claims processing, payment accuracy, defect management, and resolution of complex claims issues.
You will work collaboratively with business analysts, developers, and upstream teams to help ensure accurate and compliant claims processing.
In this role, you will:
Lead end-to-end testing activities for Medicare claims, independently managing test planning, execution, defect management, and overall testing delivery.
Apply strong healthcare payer and claims expertise while testing solutions involving HRP, ClaimXten, and/or Cotiviti.
Lead defect management and root cause analysis for failed claims, system errors, and claims-processing issues, partnering with business analysts, developers, and upstream teams to drive resolution.
Validate claims-processing behavior, reimbursement accuracy, claims edits, and payment-related outcomes.
Support testing of CMS-driven pricing changes, release-related variances, and Medicare claims compliance risks where applicable.
Work model
We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a Remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.
The working arrangements for this role are accurate as of the date of posting. This may change based on the project you’re engaged in, as well as business and client requirements. Rest assured, we will always be clear about role expectations.
What you need to have to be considered
10+ years of strong healthcare payer domain expertise, particularly in claims processing and testing.
Hands-on experience with HRP, ClaimXten, and/or Cotiviti.
Strong experience in Medicare claims testing.
Test management experience with the ability to independently lead testing activities and drive project-level testing delivery.
Experience with defect management, root cause analysis, and resolution of complex claims-processing or system issues.
These will help you stand out
Experience with HealthEdge Source / Payment Accuracy testing.
Experience validating CMS-driven pricing changes affecting Medicare claims.
Knowledge of release-related claims and pricing variances.
Experience validating reimbursement and payment accuracy.
Understanding of claims edits and compliance risks associated with Medicare claims.
We're excited to meet people who share our mission and can make an impact in a variety of ways. Don't 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.
Salary and Other Compensation
The annual salary for this position is between $71,100 to $110,000 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.
Benefits
• 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
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.
