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.
A comunidade Cognizant:
Somos uma equipe de alto calibre que aprecia e apoia uns aos outros. Nosso pessoal defende um local de trabalho enérgico, colaborativo e inclusivo, onde todos possam prosperar.
- A Cognizant é uma comunidade global com mais de 300,000 funcionários em todo o mundo.
- Não sonhamos apenas com um caminho melhor – nós fazemos acontecer.
- Cuidamos de nossas pessoas, clientes, empresa, comunidades e clima fazendo o que é certo.
- Promovemos um ambiente inovador onde você pode construir o plano de carreira certo para você.
Quem somos:
Cognizant (NASDAQ: CTSH) é uma construtora de IA e fornecedora de serviços de tecnologia, criando a ponte entre o investimento em IA e o valor para as empresas por meio do desenvolvimento de soluções de IA completas para nossos clientes. Nossa profunda experiência em setores, processos e engenharia nos permite incorporar o contexto único de cada organização em sistemas tecnológicos que potencializam a capacidade humana, geram retornos concretos e mantêm empresas globais à frente em um mundo em rápida transformação. Saiba mais em www.cognizant.com ou @cognizant.
A Cognizant é uma empregadora que investe em equidade. Sua candidatura não será pautada em raça, cor, gênero, sexualidade, credo, origem, deficiência, gravidez ou qualquer outra característica protegida pelas leis brasileiras.
Disclaimer:
As informações de compensação são precisas a partir da data desta publicação. A Cognizant se reserva o direito de modificar essas informações a qualquer momento, sujeito à lei aplicável.
Os candidatos podem ser obrigados a comparecer a entrevistas presenciais ou por videoconferência. Além disso, os candidatos podem ser obrigados a apresentar seu documento de identificação emitido pelo estado ou governo atual durante cada entrevista.
Embora nosso sistema permita a candidatura em todos os idiomas, o(s) idioma(s) e o(s) nível(is) de proficiência exigidos para o trabalho variam. No entanto, é necessário um nível básico de inglês para fins de comunicação em toda a empresa.
Se você tem uma deficiência que requer adaptações razoáveis para procurar uma vaga de emprego ou enviar uma candidatura, envie um e-mail para [email protected] com sua solicitação e informações de contato.