Medical Claims Processor - Remote

Cognizant is a large IT Consulting Firm that leverages modern technologies to transform a variety of business operations. We are seeking Fully Remote US Based Claims Processors to join our growing team. Claim processors will review claim submissions, verify information, adjudicate or adjust the claim as per claim processing guidelines to ensure appropriate payment or denial as per the business requirements.Role ResponsibilitiesExamine and enter basic claims for appropriateness of care and completeness of information in accordance with accepted coverage guidelines, ensuring all mandated government and state regulations are consistently metProcess claims for multiple plans with automated and manual differences in benefits, as well as utilizing the system and written documentation to determine the appropriate payment for a specific benefitApprove pending or denying payment according to the accepted coverage guidelinesFollow all team procedures, including HIPAA policies and procedures, and meets team quality, turnaround time and productivity performance standards and goalsIdentify and refer to all claims with potential third party liability (i.e., subrogation, COB, MVA, stop loss claims, and potential stop loss files)Maintain internal customer relations by interacting with staff regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing information, and updating information to claim file with regard to claims status, questions or claim paymentsOther duties as assignedMust be willing to work overtime when the business need requireDesired Skills & ExperienceAt least a High School Diploma or equivalent is requiredA minimum of 2-3 years of medical claims processing is requiredAbility to work independentlyStrong attention to detailStrong interpersonal, time management and organizational skillsGood oral/written communication and analytical skillsMust be able to work in a high performance environment that changes oftenExperience in navigating multiple systems using dual monitorsKnowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes, and standard of billing guidelines required.FACETS experience (highly preferred)Medicaid knowledge (required)Keyboard skills of at least 35 WPM + 10-keyProficient in Microsoft Office – Excel, Word, and OutlookHealthcare claims payer processing experience (required)Ability to work in a high pace while maintaining quality and productivity targetsWorking Environment RequirementAbility to work remotely in a secure environment (Required)Must have high-speed internet connection ( Required)Must have highs-speed internet modem with ability to connect laptop to wired connection port (Required)Must have a workspace and location free from distractions and safety of healthcare data (Required)Salary and Other CompensationThe hourly rate for this position is between $16 – $19 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.BenefitsMedical/Dental/Vision/Life InsurancePaid holidays plus Paid Time Off401(k) plan and contributionsLong-term/Short-term DisabilityPaid Parental LeaveEmployee Stock Purchase PlanDisclaimer: 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 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.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.J-18808-Ljbffr