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.
Acerca de Cognizant
Cognizant (Nasdaq: CTSH) es un creador de soluciones de IA y proveedor de servicios tecnológicos que conecta la inversión en IA con el valor empresarial mediante el desarrollo de soluciones de IA full‑stack para sus clientes. Su profundo conocimiento de la industria, junto con su experiencia en procesos e ingeniería, permite incorporar el contexto único de cada organización en sistemas tecnológicos que amplifican el potencial humano, generan resultados tangibles y mantienen a las empresas a la vanguardia en un entorno en constante cambio. Más información en cognizant.ai o @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.
