Job Summary
Serve as a specialist in enrollment and billing for a global payer organization ensuring accurate member data maintenance and compliant billing operations in a hybrid night shift role. Apply strong MS Office proficiency and working knowledge of HIPAA standards to support timely processing issue resolution and continuous improvement of payer enrollment and billing workflows.
Responsibilities
Manage end to end member enrollment activities by accurately capturing validating and updating payer data within internal systems to support timely coverage activation and billing accuracy.Process billing transactions for premiums adjustments and reconciliations with close attention to detail to reduce financial discrepancies and support reliable revenue cycles.Analyze enrollment and billing input files reports and transaction logs using MS Office tools to identify data issues trends and reconciliation gaps that require corrective actions.Coordinate with internal operations client service and technology teams through clear and structured communication to resolve enrollment and billing queries within agreed timelines.Maintain strict adherence to HIPAA requirements by handling protected health information with confidentiality and following documented privacy and security controls.Create and maintain structured logs trackers and status reports in spreadsheets to monitor work volumes turnaround times and error rates for ongoing operational transparency.Review enrollment forms eligibility feeds and billing records against payer rules to validate completeness accuracy and compliance with contractual and regulatory guidelines.Investigate member or client reported discrepancies in enrollment status or billing amounts document root causes and execute corrections to minimize rework and dissatisfaction.Utilize productivity and quality metrics to prioritize daily workload manage peak volumes in the night shift and consistently meet or exceed service commitments.Document standard operating procedures exception handling steps and job aids in clear and structured formats to support team consistency and future training needs.Collaborate with quality and process excellence teams to suggest enhancements that streamline enrollment and billing workflows and reduce manual data handling effort.Support system testing activities related to enrollment and billing changes by executing predefined test cases validating results and documenting issues for follow up.Adapt to hybrid work expectations by maintaining reliable virtual collaboration secure data handling practices and consistent performance across onsite and remote settings.
Qualifications
Possess foundational experience in payer operations with exposure to enrollment and billing processes that demonstrates understanding of eligibility premiums and coverage rules.Apply strong working knowledge of MS Office with emphasis on spreadsheets word processing and presentations to prepare reports analyze data and communicate findings clearly.Demonstrate practical understanding of HIPAA concepts related to privacy security and permissible use of health information to ensure compliant day to day processing.Exhibit effective written and verbal communication skills to interact with cross functional stakeholders and respond to client queries in a clear and professional manner.Show capability to work consistently in a night shift hybrid environment by managing time focus and well being while maintaining productivity and accuracy.Display analytical thinking and problem solving abilities that support investigation of enrollment and billing issues and formulation of fact based corrective actions.Illustrate eagerness to learn payer products benefit structures and system functionalities to grow into more complex enrollment and billing responsibilities over time.
Sobre a Cognizant
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 resultados tangíveis e mantêm empresas globais à frente em um mundo em rápida transformação. Saiba mais em cognizant.ai 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.
Informações adicionais de emprego
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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.
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.
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.
