Job Summary
This role involves providing specialized expertise in claims adjudication within the healthcare domain. The candidate will work from the office during night shifts ensuring accurate and efficient claims processing. The position requires a minimum of 2 years and a maximum of 4 years of relevant experience with a focus on delivering high-quality outcomes.
Responsibilities
- Analyze and process healthcare claims with precision ensuring compliance with adjudication guidelines and policies.
- Collaborate with internal teams to resolve discrepancies and ensure seamless claims adjudication workflows.
- Monitor claims data for accuracy and identify patterns or anomalies that may require further investigation.
- Utilize technical expertise in claims adjudication to optimize processing times and reduce errors.
- Provide detailed documentation and reports on adjudicated claims for auditing and review purposes.
- Ensure adherence to regulatory requirements and company standards in all claims processing activities.
- Communicate effectively with stakeholders to address queries and provide clarifications regarding claims adjudication.
- Stay updated on industry trends and changes in healthcare claims policies to maintain expertise in the domain.
- Support the implementation of process improvements to enhance efficiency and accuracy in claims adjudication.
- Participate in training sessions and knowledge-sharing initiatives to strengthen team capabilities.
- Leverage domain skills in commercial claims payer systems and claims management to deliver impactful results.
- Contribute to the companys mission by ensuring timely and accurate processing of claims positively impacting customer satisfaction.
- Maintain confidentiality and integrity in handling sensitive healthcare claims data. Qualifications
- Demonstrate proficiency in claims adjudication processes and possess hands-on experience in healthcare claims systems.
- Exhibit strong analytical skills to identify and resolve issues in claims processing efficiently.
- Showcase familiarity with commercial claims payer systems and claims management as a nice-to-have domain expertise.
- Display excellent communication skills to interact effectively with stakeholders and team members.
- Possess a detail-oriented mindset to ensure accuracy and compliance in all adjudication tasks.
- Show adaptability to work in night shifts and deliver consistent performance in a dynamic environment.
- Highlight a commitment to continuous learning and staying updated on industry standards and best practices.
Certifications Required
Certified Professional Coder (CPC) Certified Claims Specialist (CCS)
Acerca de nosotros
Cognizant (NASDAQ: CTSH) es arquitecto de soluciones de IA y proveedor de servicios tecnológicos que traduce la inversión en inteligencia artificial en valor empresarial real mediante soluciones de IA de stack completo adaptadas a cada cliente. Su profundo conocimiento de la industria, los procesos y la ingeniería le permite integrar el contexto único de cada organización en sistemas tecnológicos que amplifican el potencial humano, generan un impacto real en el negocio y mantienen a las grandes empresas globales un paso adelante en un mundo en constante cambio. Para más información, visita www.cognizant.es o síguenos en @cognizant.
Información adicional sobre el empleo
La información sobre la compensación es exacta en la fecha de publicación de este anuncio. Cognizant se reserva el derecho de modificar esta información en cualquier momento, de conformidad con la legislación aplicable.
Es posible que se solicite a los solicitantes que asistan a entrevistas de forma presencial o mediante videoconferencia. Asimismo, durante cada entrevista, los candidatos podrán estar obligados a presentar un documento de identidad válido emitido por el estado o por el gobierno.
Cognizant es un empleador que ofrece igualdad de oportunidades. Su solicitud y candidatura no se evaluarán en función de la raza, el color, el sexo, la religión, el credo, la orientación sexual, la identidad de género, el origen nacional, la discapacidad, la información genética, el embarazo, la condición de veterano ni cualquier otra característica protegida por las leyes federales, estatales o locales.
