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. Claim processors will review claim submissions, verify information, adjudicate or adjust the claim as per claim processing guidelines to ensure appropriate payment or denial as per the business requirements.
Role Responsibilities
- Examine and enter basic claims for appropriateness of care and completeness of information in accordance with accepted coverage guidelines, ensuring all mandated government and state regulations are consistently met
- Process claims for multiple plans with automated and manual differences in benefits, as well as utilizing the system and written documentation to determine the appropriate payment for a specific benefit
- Approve pending or denying payment according to the accepted coverage guidelines
- Follow all team procedures, including HIPAA policies and procedures, and meets team quality, turnaround time and productivity performance standards and goals
- Identify and refer to all claims with potential third party liability (i.e.,. subrogation, COB, MVA, stop loss claims, and potential stop loss files)
- Maintain internal customer relations by interacting with staff regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing information, and updating information to claim file with regard to claims status, questions or claim payments
- Other duties as assigned
- Must be willing to work overtime when the business need require
Desired Skills & Experience
- At least a High School Diploma or equivalent is required
- A minimum of 2-3 years of medical claims processing is required
- Ability to work independently
- Strong attention to detail
- Strong interpersonal, time management and organizational skills
- Good oral/written communication and analytical skills
- Must be able to work in a high performance environment that changes often
- Experience in navigating multiple systems using dual monitors
- Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes, and standard of billing guidelines required.
- FACETS experience (highly preferred)
- Medicaid knowledge (required)
- Keyboard skills of at least 35 WPM + 10-key
- Proficient in Microsoft Office – Excel, Word, and Outlook
- Healthcare claims payer processing experience (required)
- Ability to work in a high pace while maintaining quality and productivity targets
Working Environment Requirement
- Ability to work remotely in a secure environment (Required)
- Must have high-speed internet connection ( Required)
- Must have highs-speed internet modem with ability to connect laptop to wired connection port (Required)
- Must have a workspace and location free from distractions and safety of healthcare data (Required)
Salary and Other Compensation
Applications will be accepted until May 22nd, 2026.
The hourly rate for this position is between $16 – $19 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 communauté Cognizant :
Nous sommes une équipe de professionnels dont les membres s'apprécient et se soutiennent mutuellement. Nos collaborateurs sont les garants d'un lieu de travail dynamique, collaboratif et inclusif où chacun peut s'épanouir.
- Cognizant est une communauté mondiale qui compte plus de 300 000+ collaborateurs dans le monde entier.
- Nous ne nous contentons pas de rêver de façons idéales, nous apportons des améliorations concrêtes
- Nous prenons soin de nos collaborateurs, de nos clients, de notre entreprise, de nos communautés et du climat, en faisant ce qui est juste.
- Nous favorisons un environnement innovant où vous pouvez construire le plan de carrière qui vous convient.
À propos de nous :
Cognizant (NASDAQ : CTSH) est un concepteur d’IA et un fournisseur de services technologiques. Avec notre gamme de solutions IA full-stack, nous accompagnons nos clients au carrefour de l’investissement dans l’IA et de la valeur ajoutée. Notre grande expertise sectorielle, des processus et de l’ingénierie nous permet de convertir le contexte propre à chaque entreprise en systèmes technologiques amplificateurs du potentiel humain, générateurs de résultats tangibles et garants de l’avantage des acteurs internationaux dans un monde en constante évolution. Découvrez notre méthode sur www.cognizant.com ou suivez @cognizant.
Cognizant est un employeur soucieux de l'égalité des chances entre candidats. Votre candidature sera étudiée indépendamment de votre race, couleur, sexe, religion, croyances, orientation sexuelle, identité de genre, origine, handicap, informations génétiques, grossesse, statut d'ancien militaire ou de toute autre critère jugé discriminant par les lois européennes ou françaises.
Vous êtes porteur d'un handicap, vous pouvez-nous contacter par courriel [email protected] si vous souhaitez préciser les aménagements nécessaires pour le poste ou les entretiens à venir.
Mentions légales :
Les informations relatives à la rémunération du poste à pourvoir dépendent de la date de publication de l’offre de poste. Cognizant se réserve le droit de modifier ces informations à tout moment, sous réserve des lois applicables.
Les candidats peuvent être invités à participer à des entretiens en face à face ou par vidéoconférence. En outre, les candidats peuvent être amenés à présenter une carte d'identité valide lors de chaque entretien.