Claims Processor - Remote

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. Cognizant is looking to expand the AR- Immersive Specialist team and your skills are needed! Are you interested? If so, please apply in order to be considered. We look forward to reviewing your application!

The Claim Processing position is responsible for timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client for 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.

• Responsible for reviewing the data in the claim processing system, and comparing with corresponding UB or HCFA paper or EDI information.
• Responsible for reviewing medical records when necessary to determine if service rendered was medically appropriate and criteria has been met.
• Responsible for reviewing claim and line item edits and warning messages for determination of whether to pay claim/line item(s).
• Ensuring all designated tasks are handled within the appropriate timeframe in order to meet internal and external SLAs
• Assigning special projects or other duties as determined by management.
• Possess ability to work at a computer for extended periods.

• A minimum of 1 years claims processing is required
• Knowledge of physician practice and hospital coding, billing and medical terminology, CPT, HCPCS, ICD-9
• Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims
• Knowledge of Medicare billing & payment and coverage guidelines and regulations
• Experience in the analysis and processing of claims, utilization review/quality assurance procedures
• Must be able to work with minimal supervision.
• Creative thinker with good skills a problem resolution specifically related to healthcare claim adjudication
• Will work closely with other departments
• Requires High School degree or GED or equivalent experience.

The hourly rate for this position is between $13.00 - $18.00 per 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.

Applications will be accepted through January 31st.

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.

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

If you have a disability that requires a reasonable accommodation to search for a job opening or submit an application, please email CareersNA2@cognizant.com with your request and contact information. Applications are accepted on an ongoing basis.