Job Summary
Serve as a specialist in enrollment and billing operations within healthcare products applying expertise in eligibility and benefit verification demographic data entry and claim or charge entry. Contribute to accurate member onboarding precise billing and smooth revenue workflows in a work from office day shift model ensuring compliance and high quality service delivery.
Responsibilities
Manage end to end enrollment processing within healthcare products to ensure accurate and timely member onboarding that supports reliable coverage activation and billing integrity.Execute detailed eligibility and benefit verification activities to confirm member coverage parameters and minimize claim denials while strengthening trust in healthcare plan accuracy.Perform precise demographic data entry for member and subscriber records to maintain high quality datasets that drive accurate billing communications and regulatory reporting.Handle claim and charge entry tasks with strong attention to detail to support clean claim submissions and efficient reimbursement cycles for healthcare services.Monitor daily work queues for enrollment and billing transactions to prioritize tasks effectively and support consistent throughput in a work from office day schedule.Collaborate with operations and billing colleagues to resolve data inconsistencies or missing information that may impact eligibility verification and claim accuracy.Use healthcare product systems and related applications to research member records and update enrollment details in alignment with policy guidelines and compliance controls.Investigate basic discrepancies in premium calculations or claim charge data and escalate complex issues through defined channels to safeguard financial accuracy.Apply knowledge of eligibility and benefit rules to identify potential errors in member setup and proactively correct records to enhance downstream claim processing.Maintain comprehensive documentation of enrollment and billing actions taken within case management tools to support audit readiness and operational transparency.Adhere to organizational standards for data privacy and security while handling sensitive member information in an office based environment without travel requirements.Contribute to continuous improvement initiatives by sharing observations on recurring data or process issues that affect enrollment quality and claim workflows.Support cross functional collaboration by providing clear operational insights to teams focused on customer service and provider relations so business outcomes and societal impact are enhanced.
Qualifications
Possess hands on experience working with healthcare products and operational systems that manage member enrollment and billing transactions in a structured environment.Demonstrate practical knowledge in eligibility and benefit verification including interpreting coverage details and applying rules to real world member scenarios.Show proven capability in demographic data entry with strong typing accuracy and data validation habits to support clean member record maintenance.Bring direct experience in claim and charge entry processes including coding basic service information and validating figures for processing consistency.Hold one to three years of exposure to healthcare domain operations with focus on enrollment billing eligibility verification and transaction based workflows.Exhibit familiarity with regulatory and compliance expectations related to healthcare data handling and member information management.Display strong analytical and problem solving skills to identify root causes of data or process variances and implement practical corrections.Demonstrate effective communication and collaboration abilities suited to an office based day shift environment that relies on teamwork and clear documentation.
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.
