Cognizant is a large IT Consulting Firm that leverages modern technologies to transform a variety of business operations. We are seeking Fully Remote US Based Claims Processors to join our growing team. The Claims Processor is responsible for the timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client for issues related to claims adjudication and adjustments, Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the Plan Document.
Role Responsibilities
- Responsible for reviewing the data in the claim processing system (Facets) and comparing it with the corresponding UB, HCFA paper, or EDI information.
- Responsible for reviewing medical records when necessary to determine if the service rendered was medically appropriate and criteria has been met.
- Responsible for reviewing claim and line item edits and warning messages for determination of whether to pay claim/line item(s).
- Ensure that all designated tasks are handled within the appropriate timeframe in order to meet internal and external SLAs
- Assigned special projects or other duties as determined by management.
- Will work closely with other departments
Desired Qualifications
- At least a High School Diploma or equivalent is required
- A minimum of 1 years claims processing is required
- Facets experience is highly preferred
- Knowledge of physician practice and hospital coding, billing, and medical terminology, CPT, HCPCS, ICD-9
- Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims
- Knowledge of Medicare billing & payment and coverage guidelines and regulations
- Experience in the analysis and processing of claims, utilization review/quality assurance procedures
- Must be able to work with minimal supervision.
- Creative thinker with good problem-solving skills specifically related to healthcare claim adjudication
- Possess the ability to work at a computer for extended periods.
- Must have basic Microsoft Excel skills
Salary and Other Compensation
Applications will be accepted until July 11th, 2025.
The hourly rate for this position is between $15.20 – $17.75 per hour, 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: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
- 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
Disclaimer: The hourly rate, other compensation, and benefits 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.
Cognizant will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.
La Comunidad Cognizant:
Somos un equipo que se aprecia y apoya mutuamente. Nuestros asociados trabajan en un entorno colaborativo e integrador en el que todos pueden prosperar.
- Cognizant es una comunidad global con más de 300.000+ asociados en todo el mundo.
- No solo soñamos con un mundo mejor, sino que trabajamos para hacerlo realidad.
- Cuidamos de nuestros asociados, clientes, socios, comunidades y entorno haciendo lo correcto.
- Fomentamos un entorno innovador en el que puedes desarrollar tu carrera profesional.
Acerca de nosotros
Cognizant es una de las principales empresas de servicios profesionales del mundo, transformando los modelos de negocio, operativos y tecnológicos de los clientes para la era digital. Nuestro enfoque consultivo único, basado en la industria, ayuda a los clientes a visualizar, construir y gestionar negocios más innovadores y eficientes. Con sede en los EE. UU., Cognizant (miembro del NASDAQ-100 y uno de los mejores empleadores del mundo según Forbes en 2024) está constantemente listado entre las empresas más admiradas del mundo. Descubra cómo Cognizant ayuda a los clientes a liderar con lo digital en www.cognizant.com.
Cognizant es un empleador que ofrece igualdad de oportunidades. Tu solicitud y candidatura no serán consideradas en base a raza, color, sexo, religión, credo, orientación sexual, identidad de género, origen nacional, discapacidad, información genética, embarazo, condición de veterano o cualquier otra característica protegida por las leyes federales, estatales o locales.
Si tienes alguna discapacidad que requiera ciertas adaptaciones para buscar un puesto de trabajo o presentar una solicitud, envía un correo electrónico a [email protected] con tu solicitud e información de contacto.
Advertencia:
La información sobre remuneración es exacta a la fecha de esta publicación. Cognizant se reserva el derecho a modificar esta información en cualquier momento, sujeto a la legislación aplicable.Es posible que los candidatos deban asistir a entrevistas en persona o por videoconferencia e, incluso, que tengan presentar su documento de identidad vigente, durante cada entrevista.