Job Summary
Serve as a hands on enrollment and billing team lead for a global healthcare client overseeing end to end activities in benefits open enrollment and billing operations under HIPAA compliant processes. Collaborate with payer and provider stakeholders in a hybrid work model with consistent night shift coverage to ensure accurate timely and compliant member transactions.
Responsibilities
- Lead day to day enrollment and billing processing activities to ensure accurate member data capture and timely billing outcomes across payer and provider lines of business.
- Oversee benefits open enrollment tasks by validating eligibility coverage elections and premium calculations to minimize downstream financial and service errors.
- Coordinate with internal payer operations teams to clarify complex benefit rules and ensure that enrollment decisions are applied consistently across plans and member segments.
- Work closely with provider operations teams to align member enrollment records with provider participation data so that claims handling and billing activities remain accurate and efficient.
- Review queued transactions and work items in enrollment and billing systems during the night shift to ensure service level commitments and turnaround timelines are consistently met.
- Analyze enrollment discrepancies and billing exceptions to identify root causes and recommend corrective actions that reduce rework and improve member satisfaction.
- Document operational procedures for enrollment and billing processes to promote standardization knowledge sharing and consistent adherence to HIPAA compliant guidelines.
- Collaborate with compliance and data privacy stakeholders to ensure all enrollment and billing work products align with HIPAA requirements and enterprise security expectations.
- Partner with cross functional teams including customer service claims and finance to resolve complex member or group level billing issues in a proactive and transparent manner.
- Monitor key performance indicators related to benefits enrollment accuracy billing timeliness and error rates to support continuous improvement initiatives.
- Provide clear operational feedback to product and technology teams on system defects usability challenges and enhancement opportunities for enrollment and billing platforms.
- Participate in hybrid model collaboration sessions and virtual meetings during night hours to align work priorities and share insights on payer and provider domain trends.
- Contribute to organization wide initiatives that enhance healthcare affordability and accessibility by ensuring precise enrollment handling and reliable billing information.
Qualifications
- Possess four to five years of experience in healthcare enrollment and billing operations with proven exposure to benefits open enrollment cycles.
- Demonstrate strong working knowledge of HIPAA regulations with the ability to apply privacy and security expectations to daily transaction handling and documentation.
- Exhibit deep understanding of both payer and provider domains including plan structures provider networks and reimbursement implications of enrollment decisions.
- Apply advanced analytical skills to interpret enrollment files premium reports and reconciliation outputs while identifying trends and anomalies.
- Utilize excellent communication skills to interact effectively with global stakeholders across business operations and technology functions in a hybrid environment.
- Show adaptability to consistent night shift schedules with the discipline to manage workloads priorities and personal well being.
- Display familiarity with common healthcare enrollment and billing systems along with proficiency in spreadsheets and basic reporting tools for data validation.
- Maintain a continuous learning mindset by staying current on regulatory changes payer policies and provider contract nuances that influence enrollment outcomes.
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.
Zusätzliche Informationen zur Beschäftigung
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