Healthcare Claims Processor (remote)
This is a remote position open to any qualified applicant in the United States.
Cognizant, a Fortune 200 corporation, is looking for Healthcare Claims Processors to support the daily operations of a multi-disciplinary team. The candidate must come with experience in documentation research and retaining system information.
Responsibilities:
- Claims Adjudication / Adjustment
- Working on multiple screens, conducting hands-on claims processing.
- Review and scrutinize claims and process claims into the computer system as per the provided DLPs/guidelines.
- Determine accurate claims payment or denial, identify, and elevate dubious claims or system issues to process the claim accurately.
- Process claims in a timely manner, as per the required TAT.
- Correct errors or omissions on claim and investigate questionable data.
- To maintain Quality as per the SLA
- To maintain Productivity as per the SLA
- Continuously meet and exceed the assigned Targets
- Performance should be maintained in accordance with the process performance parameters
- To maintain confidentiality while processing all information
- To follow all regulatory requirements and procedures as per the company policy
EDUCATION and EXPERIENCE
- High School Diploma or GED
- Minimum 1 year experience processing healthcare claims
- Excellent communication and interpersonal skills
Preferred Qualifications:
- Facets experience is a plus
- Experience reviewing and processing HCFA 1500 and UB04 preferred