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Process Executive - HC

eine Gruppe von Frauen, die in einer Reihe sitzen


Job Summary

We are seeking a Process Executive - HC with 0 to 1 years of experience to join our team. The ideal candidate will have expertise in Facets - Claims and Claims Adjudication along with domain experience in Dental Claims and Commercial Claims. This is a hybrid role with night shifts and no travel is required. Proficiency in English is essential.


Responsibilities

  • Process claims accurately and efficiently using Facets
  • Claims and Claims Adjudication systems.
  • Ensure all Dental Claims and Commercial Claims are processed in compliance with company policies and industry standards.
  • Review and verify claim information to ensure completeness and accuracy.
  • Identify and resolve discrepancies in claim submissions.
  • Maintain up-to-date knowledge of industry regulations and guidelines related to claims processing.
  • Collaborate with team members to ensure timely and accurate claim adjudication.
  • Provide support and assistance to other team members as needed.
  • Communicate effectively with internal and external stakeholders to resolve claim issues.
  • Document all claim processing activities accurately and thoroughly.
  • Participate in training sessions to stay current with system updates and changes.
  • Contribute to process improvement initiatives to enhance efficiency and accuracy.
  • Ensure confidentiality and security of all claim information.
  • Meet or exceed performance metrics and quality standards set by the company.

    • Qualifications

  • Possess strong technical skills in Facets
  • Claims and Claims Adjudication.
  • Have domain expertise in Dental Claims and Commercial Claims.
  • Demonstrate proficiency in English with the ability to read write and speak at a novice level.
  • Exhibit attention to detail and strong analytical skills.
  • Show ability to work effectively in a hybrid work model with night shifts.
  • Display excellent communication and interpersonal skills.
  • Have a commitment to maintaining confidentiality and security of sensitive information.

    • Certifications Required

    Certified Claims Professional (CCP) or equivalent certification in claims processing.

    The Cognizant community:
    We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive.

    • Cognizant is a global community with more than 300,000+ associates around the world.
    • We don’t just dream of a better way – we make it happen.
    • We take care of our people, clients, company, communities and climate by doing what’s right.
    • We foster an innovative environment where you can build the career path that’s right for you.

    About us:
    Cognizant is one of the world's leading professional services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build, and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant (a member of the NASDAQ-100 and one of Forbes World’s Best Employers 2024) is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com

    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, state 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.

    Disclaimer:
    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.

    Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.

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