Job Summary
Serve as a specialist in enrollment and billing operations for payer clients ensuring accurate member data management and compliant premium processing within a hybrid night shift model. Apply strong MS Office skills and HIPAA knowledge to maintain data integrity support issue resolution and contribute to reliable healthcare coverage for members and providers.
Responsibilities
- Manage end to end enrollment processing activities to ensure timely and accurate setup of member records for payer clients in alignment with plan rules and regulatory expectations.
- Coordinate billing cycles for premiums and adjustments to maintain precise financial records that support stable revenue flow and reliable coverage for members.
- Validate member eligibility demographic details and product selections using MS Office tools to reduce errors and avoid downstream claim processing issues.
- Analyze enrollment and billing discrepancies by comparing source data system records and payer reports to identify root causes and propose corrective actions.
- Document all enrollment and billing actions in standard templates using spreadsheets and word processing tools to create auditable transaction histories.
- Apply HIPAA privacy concepts during daily handling of protected health information to safeguard member data and support regulatory compliance.
- Respond to internal queries on enrollment status premium amounts and account changes with clear and timely explanations that enable informed decisions.
- Collaborate with cross functional operations and quality teams to refine enrollment and billing workflows that enhance accuracy speed and member satisfaction.
- Track work items and service level targets to ensure all enrollment and billing tasks are completed within agreed timelines and quality thresholds.
- Support testing of minor system changes or configuration updates by executing defined scenarios and documenting observed issues for technical teams.
- Prepare recurring operational reports using spreadsheets to summarize volumes errors and trends that inform process improvements.
- Assist in creating and updating standard operating procedures for enrollment and billing tasks so that knowledge is captured and consistently applied.
- Adapt to a hybrid night shift work environment while maintaining productivity clear communication and adherence to all security guidelines.
Qualifications
- Understand payer domain concepts such as member eligibility plan benefits premium rules and coordination of benefits sufficient to interpret enrollment and billing scenarios accurately.
- Use MS Office applications with strong proficiency including spreadsheets for data analysis word processors for documentation and presentations for simple status updates.
- Apply HIPAA knowledge in practical situations by recognizing sensitive data following access protocols and supporting secure information exchange.
- Demonstrate at least one year of experience in enrollment billing or similar payer operations functions with attention to detail and error prevention.
- Communicate clearly in both written and verbal form with operations teams supervisors and where applicable client contacts to resolve issues efficiently.
- Manage time effectively during night shifts in a hybrid work setup by organizing tasks prioritizing queues and meeting daily production and quality goals.
- Show willingness to learn new payer products system features and updated guidelines to keep enrollment and billing practices current and effective.
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
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.
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.
