Job Summary
This hybrid role for a Claims Healthcare Specialist Product Engineer focuses on designing developing and securing claims processing solutions using advanced software practices MS Excel analytics and generative AI ensuring accurate adjudication and compliance for healthcare stakeholders while improving operational efficiency and patient centric outcomes across the organization.
Responsibilities
Design robust healthcare claims processing solutions that streamline adjudication workflows and enhance accuracy across core business processes for internal and external stakeholders.Develop modular software components for claims intake validation and settlement that are optimized for maintainability performance and alignment with healthcare compliance standards.Apply MS Excel to build detailed data analysis models dashboards and reconciliation reports that highlight claims trends anomalies and process optimization opportunities.Implement software security requirements across claims applications by defining secure data handling patterns and enforcing controls that protect sensitive health information throughout its lifecycle.Use generative AI techniques to design and refine intelligent features such as automated documentation assistance and claim pattern detection that reduce manual effort and error rates.Collaborate with business analysts and healthcare operations teams to translate claims policies benefit rules and regulatory constraints into clear and testable software requirements.Conduct unit integration and regression testing of claims modules to confirm functional accuracy security behavior and end to end reliability in line with agreed quality standards.Maintain detailed technical documentation for claims solutions including design decisions security considerations and configuration guidelines to support continuous improvement and onboarding.Monitor production claims systems by reviewing logs error reports and performance metrics then implement targeted fixes and enhancements that sustain system stability and user satisfaction.Optimize existing claims workflows by analyzing operational data in MS Excel and proposing focused automation or rule refinements that shorten settlement timelines and reduce rework.Integrate generative AI services into claims platforms in a controlled manner by validating models against healthcare data quality expectations and documenting safeguards for responsible use.Coordinate with cybersecurity and compliance specialists to ensure all claims software releases satisfy current healthcare privacy regulations and internal risk management policies.Contribute to cross functional initiatives that use claims insights to improve care pathways and cost transparency reinforcing the company mission to deliver better health outcomes and societal impact.
Qualifications
Demonstrate between two and four years of hands on experience in software design and development with specific exposure to healthcare or financial claims systems considered a strong asset.Possess strong practical skills in MS Excel including formulas pivot analysis and data validation combined with solid understanding of software security requirements in regulated environments.Show working experience with generative AI concepts and tools applied to documentation support pattern discovery or workflow optimization within enterprise technology contexts.Bring domain knowledge in healthcare claims processing or insurance operations as a required competency with familiarity across related regulatory and compliance frameworks viewed as beneficial.Offer good to have experience in adjacent domains such as provider billing policy administration or clinical data integration that deepens perspective on end to end healthcare value chains.Work within a hybrid model that balances on site collaboration and remote productivity maintaining clear communication and reliable delivery of commitments in both settings.Operate primarily in a day shift schedule that supports coordination with global stakeholders while preserving flexibility for project demands and incident support when needed.Accept that this position does not require routine travel while remaining open to occasional short visits that may be arranged for critical workshops or stakeholder engagements.Communicate effectively in English through documentation analysis discussions and solution presentations enabling alignment among technical and nontechnical participants.
Certifications Required
Preferred certifications include AZ 900 Microsoft Azure Fundamentals or equivalent security focused credential relevant to enterprise software solutions.
Acerca de Cognizant
Cognizant (Nasdaq: CTSH) es un creador de soluciones de IA y proveedor de servicios tecnológicos que conecta la inversión en IA con el valor empresarial mediante el desarrollo de soluciones de IA full‑stack para sus clientes. Su profundo conocimiento de la industria, junto con su experiencia en procesos e ingeniería, permite incorporar el contexto único de cada organización en sistemas tecnológicos que amplifican el potencial humano, generan resultados tangibles y mantienen a las empresas a la vanguardia en un entorno en constante cambio. Más información en cognizant.ai o @cognizant.
Información adicional de empleo
La información de compensación es precisa a la fecha de esta publicación. Cognizant se reserva el derecho de modificar esta información en cualquier momento, sujeto a la legislación aplicable.
Es posible que se requiera que los solicitantes asistan a entrevistas en persona o por videoconferencia. Además, es posible que se requiera que los candidatos presenten su identificación actual emitida por el estado o gobierno durante cada entrevista.
Cognizant es un empleador que ofrece igualdad de oportunidades. Tu solicitud y candidatura no serán consideradas en base a raza, color, sexo, religión, credo, orientación sexual, identidad de género, origen nacional, discapacidad, información genética, embarazo, condición de veterano o cualquier otra característica protegida por las leyes federales, estatales o locales.
Si tienes una discapacidad que requiere adaptaciones razonables para buscar una vacante de trabajo o enviar una solicitud, puedes enviar un correo electrónico a [email protected] con tu solicitud e información de contacto.
