About the role
As a Senior Healthcare Claims Test Lead, you will make an impact by leading testing initiatives for Medicare claims and healthcare payment solutions. You will independently manage testing activities across the project lifecycle, with a strong focus on claims processing, payment accuracy, defect management, and resolution of complex claims issues.
You will work collaboratively with business analysts, developers, and upstream teams to help ensure accurate and compliant claims processing.
In this role, you will:
Lead end-to-end testing activities for Medicare claims, independently managing test planning, execution, defect management, and overall testing delivery.
Apply strong healthcare payer and claims expertise while testing solutions involving HRP, ClaimXten, and/or Cotiviti.
Lead defect management and root cause analysis for failed claims, system errors, and claims-processing issues, partnering with business analysts, developers, and upstream teams to drive resolution.
Validate claims-processing behavior, reimbursement accuracy, claims edits, and payment-related outcomes.
Support testing of CMS-driven pricing changes, release-related variances, and Medicare claims compliance risks where applicable.
Work model
We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a Remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.
The working arrangements for this role are accurate as of the date of posting. This may change based on the project you’re engaged in, as well as business and client requirements. Rest assured, we will always be clear about role expectations.
What you need to have to be considered
10+ years of strong healthcare payer domain expertise, particularly in claims processing and testing.
Hands-on experience with HRP, ClaimXten, and/or Cotiviti.
Strong experience in Medicare claims testing.
Test management experience with the ability to independently lead testing activities and drive project-level testing delivery.
Experience with defect management, root cause analysis, and resolution of complex claims-processing or system issues.
These will help you stand out
Experience with HealthEdge Source / Payment Accuracy testing.
Experience validating CMS-driven pricing changes affecting Medicare claims.
Knowledge of release-related claims and pricing variances.
Experience validating reimbursement and payment accuracy.
Understanding of claims edits and compliance risks associated with Medicare claims.
We're excited to meet people who share our mission and can make an impact in a variety of ways. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.
Salary and Other Compensation
The annual salary for this position is between $71,100 to $110,000 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
• 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
Over Cognizant
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 tastbare resultaten en geven wereldwijde ondernemingen een voorsprong in een snel veranderende wereld. Ontdek hoe op cognizant.ai of @cognizant.
Aanvullende arbeidsinformatie
De informatie over de beloning is correct op de datum van deze vacature. Cognizant behoudt zich het recht voor om deze informatie op elk moment te wijzigen, met inachtneming van de toepasselijke wetgeving.
Van sollicitanten kan worden verwacht dat zij gesprekken bijwonen, persoonlijk of via een videogesprek. Daarnaast kan van kandidaten worden gevraagd om tijdens elk gesprek een geldig, door de overheid uitgegeven identiteitsbewijs (zoals een identiteitskaart of paspoort) te tonen.
Cognizant is een werkgever die gelijke kansen biedt. Je sollicitatie en kandidatuur worden niet beoordeeld op basis van ras, huidskleur, geslacht, religie, levensovertuiging, seksuele geaardheid, genderidentiteit, nationale afkomst, handicap, genetische informatie, zwangerschap, veteranenstatus of enige andere eigenschap die wordt beschermd door federale, regionale of lokale wetgeving.
