About the role
As a Senior Healthcare Claims Test Lead, you will make an impact by leading testing initiatives for Medicare claims and healthcare payment solutions. You will independently manage testing activities across the project lifecycle, with a strong focus on claims processing, payment accuracy, defect management, and resolution of complex claims issues.
You will work collaboratively with business analysts, developers, and upstream teams to help ensure accurate and compliant claims processing.
In this role, you will:
Lead end-to-end testing activities for Medicare claims, independently managing test planning, execution, defect management, and overall testing delivery.
Apply strong healthcare payer and claims expertise while testing solutions involving HRP, ClaimXten, and/or Cotiviti.
Lead defect management and root cause analysis for failed claims, system errors, and claims-processing issues, partnering with business analysts, developers, and upstream teams to drive resolution.
Validate claims-processing behavior, reimbursement accuracy, claims edits, and payment-related outcomes.
Support testing of CMS-driven pricing changes, release-related variances, and Medicare claims compliance risks where applicable.
Work model
We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a Remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.
The working arrangements for this role are accurate as of the date of posting. This may change based on the project you’re engaged in, as well as business and client requirements. Rest assured, we will always be clear about role expectations.
What you need to have to be considered
10+ years of strong healthcare payer domain expertise, particularly in claims processing and testing.
Hands-on experience with HRP, ClaimXten, and/or Cotiviti.
Strong experience in Medicare claims testing.
Test management experience with the ability to independently lead testing activities and drive project-level testing delivery.
Experience with defect management, root cause analysis, and resolution of complex claims-processing or system issues.
These will help you stand out
Experience with HealthEdge Source / Payment Accuracy testing.
Experience validating CMS-driven pricing changes affecting Medicare claims.
Knowledge of release-related claims and pricing variances.
Experience validating reimbursement and payment accuracy.
Understanding of claims edits and compliance risks associated with Medicare claims.
We're excited to meet people who share our mission and can make an impact in a variety of ways. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.
Salary and Other Compensation
The annual salary for this position is between $71,100 to $110,000 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
• 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
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.
