Summary of the Role:
The Medical Claim Advisor is responsible for daily claim processing and evaluating medical insurance claims to ensure accuracy, compliance, and timely resolution. The role involves reviewing documentation, verifying coverage and communicating with their seniors to facilitate smooth claim processing.
List of Duties:
Assess medical claims in compliance with the terms and conditions of the policy
Verify medical codes, diagnosis and procedure to ensure compliance with industry standards (e.g. ICD 9, ICD 10, CPT)
Escalate enquiries and complex cases to Senior, when necessary, in line with internal guidelines
Process claims payment in accordance with the company's objectives and guidelines
Prepare claim communication letter
Desired Professional Experience:
Minimum Diploma Holder
With minimum 1 year of experience in medical claims handling
A healthcare background is preferred
With knowledge of medical terminology, billing codes (ICD 9, ICD 10, CPT) and medical insurance policies is preferred
Strong team player, willing to learn, able to work independently and effectively under pressure
Fluent in Cantonese, Mandarin, and English (speak, read, and write).
About Cognizant:
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization’s unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.
Additional employment information
Compensation 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.
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.
Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.
If you have a disability that requires reasonable accommodation to search for a job opening or submit an application, please email [email protected] for roles based in the Americas or [email protected] for roles based in India.
