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
Quality Audit
Ensures agent compliance and adherence to client procedures / policy by reviewing agent activity within the defined quality systems
Root Cause Analysis
- Conducts weekly RCA of errors and assists in creating a weekly deck for review with operations, training, and quality team
- Assess agent performance through audit monitoring as well as 1-2-1 investigatory sessions to identify error trends and performance opportunities
- Works closely with Quality Team Lead and Manager to aggregate, prioritize, and report on the top issues impacting the program
- Contributes error analysis and insights for the preparation of the Weekly Quality reports and decks
Process Improvements
- Develop and maintain inventory of improvement ideas focused on error reduction and improvement of process health and performance
- Quality Monitoring and Coaching
- Provides analysis and recommendations for process improvement, productivity, accuracy & turnaround time
- Calibration / Global Alignment
- Attend quality calibrations and syncs to maintain alignment on process/policy understanding and application
- Perform calibration audits in sync with program SMEs and TLs to ensure audit accuracy and alignment
Communication:
- Update trackers and required applications & tools and keep management informed of emerging issues/risks
- Creation of daily, weekly, monthly reports monitoring associate and program performance to be shared with leadership
Coaching & Feedback
- Mentors / Coaches agents in relation to qualitative performance enhancement
Provides regular 1-2-1 feedback sessions with agents in correlation to quality performance and opportunities
Program Governance
- Works alongside the training team to provide insights into error trends, process gaps and performance adherence to develop assessments and knowledge checks for reviewer workflow certifications
- Monitor and adhere to policy and process change guidelines and expectations. Including providing feedback and clarification on identified changes.
- Conducts quarterly reviews of SOPs to ensure they are aligned to the current processes and policy
- Develop and maintain process documentation which outlines the quality program and approach
Personal Excellence
- Meet/Exceed targets set within the key activities
- Be an exceptional team player when it comes to knowledge sharing, training, people development and reporting
- Participate in special projects/manage individual projects, and act as a guide to ensure the project meets SLA’s
- Strives to identify new opportunities to provide a better reviewer and end-user experience
- Evaluates processes and make recommendations for improvement
- Contribute to and participate proactively in knowledge sharing sessions
- Participate and contribute to organizational activities
Desired Skills & Experience
- At least a High School Diploma or equivalent is required
- Proven expertise in all workflows
- Minimum 18 months’ experience in full-time Operations role
- Exceptional English communication skills
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 $15 – $117 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.