Cognizant is one of the world’s leading professional services companies, we help our clients modernize technology, reinvent processes, and transform experiences, so they can stay ahead in our constantly evolving world. We are looking to expand our team. Do you thrive in a busy environment and able to multi-task successfully? If so, please apply today!
The Claims Processor, you will ensure accurate and timely adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client issues related to claims adjudication and adjustments. Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the employer’s plan document. You will be valued member of the Cognizant team and collaborate with stakeholders and other teams.
Primary Responsibilities:
Review claim system data and verify against UB or HCFA paper or EDI information.
Evaluate medical records to determine if the service rendered was medically appropriate and criteria compliance.
Analyze claim and line-item edits, including warning messages, to determine payment eligibility.
Manage all tasks within designated timeline to meet internal and external SLAs.
Other duties as assigned by management.
Qualifications:
A minimum of 1 year’s claims processing experience is required.
Knowledge of physician practice and hospital coding, billing and medical terminology, CPT, HCPCA, ICD-9
Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims.
Knowledge of Medicare billing & payment and coverage guidelines and regulations.
Must be able to work with minimal supervision.
Excellent problem-solving skill in healthcare claims adjudication.
Ability to work at a computer for extended periods.
High School degree or GED or equivalent experience.
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.
Salary and Other Compensation:
Applications will be accepted until August 8, 2025
The hourly rate for this position is between $15.25 - $17.75 an 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.
