Job Summary
This hybrid entry level PE Enrollment and Billing role focuses on accurately maintaining payer member enrollment and billing records while applying strong MS Office skills and solid understanding of HIPAA guidelines. The role supports night shift operations to ensure timely processing data quality and compliant communication that enables reliable healthcare coverage and a smooth experience for members and payer partners.
Responsibilities
Process enrollment requests with careful review of member data to ensure accuracy completeness and timely updates in payer systems while adhering to standard operating procedures and night shift schedules.Update billing records using MS Office tools to reconcile premiums adjustments and corrections so that member accounts remain current and reflect correct financial information for payer reporting.Maintain enrollment and billing logs in spreadsheets with consistent data entry practices that enable clear traceability efficient audits and effective handover to other teams.Verify member eligibility and coverage details against payer rules and documentation so that downstream claims and benefits administration processes remain reliable and efficient.Respond to internal inquiries about enrollment status and billing discrepancies in a structured and courteous manner that promotes clear understanding and quick resolution.Apply HIPAA guidelines in every interaction and documentation activity so that member privacy is protected and all information handling remains compliant with regulatory expectations.Review nightly work queues and prioritize tasks based on cutoffs aging and risk to ensure that critical enrollment and billing actions are completed within defined service levels.Collaborate with payer operations teams through written updates and scheduled connects to clarify complex cases resolve data conflicts and keep shared records aligned.Identify recurring enrollment or billing issues in daily work record observations in tracking sheets and suggest process improvements that can reduce errors and rework.Use MS Office based templates and checklists to standardize documentation minimize manual mistakes and support accurate reporting for operational stakeholders.Support simple data quality checks on enrollment and billing files by running pre defined validations that prevent incorrect data from entering core payer systems.Escalate non standard or high impact issues to senior team members with structured summaries and evidence so that resolution decisions can be made quickly and effectively.Adapt to evolving payer rules benefit designs and internal policies by participating in refresher sessions and applying updated knowledge consistently in daily tasks.
Qualifications
Possess foundational knowledge of payer domain concepts such as member enrollment coverage eligibility premium billing and basic benefits terminology applied in a practical context.Demonstrate working proficiency in MS Office applications with particular focus on spreadsheets and documents used to manage lists perform simple calculations and prepare operational reports.Understand the core principles of HIPAA compliance and privacy so that member information is handled with discretion secured appropriately and shared only for valid operational needs.Show ability to learn payer specific systems and tools quickly follow documented procedures consistently and adapt to night shift routines without compromising accuracy.Exhibit strong attention to detail time management and communication skills that support reliable execution of enrollment and billing tasks in a hybrid work model.
Über Cognizant
Cognizant (NASDAQ: CTSH) i ist ein Technologiedienstleister und Entwickler von KI-Lösungen. Wir schlagen die Brücke zwischen KI-Investitionen und echtem unternehmerischem Mehrwert, indem wir ganzheitliche Full-Stack-KI-Lösungen für unsere Kunden entwickeln. Mit unserer fundierten Branchen-, Prozess- und Engineering-Expertise integrieren wir die spezifischen Anforderungen von Unternehmen passgenau in Technologiesysteme. So entfalten wir das menschliche Potenzial, erzielen greifbare Ergebnisse und sichern globalen Unternehmen in einer sich rasant wandelnden Welt den entscheidenden Vorsprung. Erfahren Sie mehr unter cognizant.ai oder @cognizant.
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