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.
De Cognizant Community
We zijn een team dat elkaar helpt om doelen te bereiken op het hoogste niveau. Zonder ons team zouden we niet in staat zijn om de huidige energieke, samenwerkende en inclusieve werkomgeving te behouden. Een omgeving gericht om iedereen te laten slagen.
- Cognizant is een globale community van 300.000+ collega’s
- We dromen niet alleen van een betere wereld, wij helpen het te maken
- We zorgen voor onze mensen, de klanten, het bedrijf, de community en het klimaat door te doen wat goed is
- We zetten in op een innovatieve omgeving waar je zelf kan bouwen aan een carriere pad dat bij jou past.
Over ons
Cognizant (NASDAQ: CTSH) is een bouwer van AI-oplossingen en een leverancier van technologiediensten. Wij slaan de brug tussen AI-investeringen en ondernemingswaarde door het bouwen van full-stack AI-oplossingen voor onze klanten. Onze diepgaande kennis van sectoren, processen en engineering stelt ons in staat om de unieke context van een organisatie te verankeren in technologische systemen. Deze systemen versterken het menselijk potentieel, realiseren tastbaar rendement en geven wereldwijde ondernemingen een voorsprong in een snel veranderende wereld. Ontdek hoe op www.cognizant.com of @cognizant.
Cognizant is een werkgever die gelijke kansen biedt. Uw sollicitatie en kandidatuur worden niet in overweging genomen op basis van ras, huidskleur, geslacht, religie, geloofsovertuiging, seksuele geaardheid, genderidentiteit, nationale afkomst, handicap, genetische informatie, zwangerschap, veteranenstatus of enig ander kenmerk dat beschermd wordt door federale, staats- of lokale wetgeving.
Disclaimer:
De informatie omtrent compensatie is accuraat ten tijde van deze posting. Cognizant heeft het recht om deze informatie aan te passen. Met lokale wetgeving in achtneming.