Claims Processor (remote)

Claims Processing (Remote)

This remote position is open to any qualified candidate living in the United States.

Job Summary

Join our team as a Claims Processing Executive in the healthcare sector where you will utilize your expertise in MS Excel to efficiently manage and process commercial claims. This remote position offers the flexibility of working from home during day shifts allowing you to balance work and personal commitments effectively. Your contributions will directly impact the accuracy and efficiency of our claims processing enhancing customer satisfaction and operational excellence.

Key Responsibilities

• Claims Processing: Review, validate, and process healthcare claims submitted by providers in accordance with US insurance policies.
• Eligibility Verification: Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid, and private insurance plans.
• Adjudication: Approve, deny, or adjust claims based on payer guidelines and policy terms.
• Compliance: Maintain adherence to HIPAA regulations, CMS guidelines, and other US healthcare compliance standards.
• Documentation: Record claim activity, maintain audit trails, and prepare reports for management.

Required Skills & Qualifications

• High school diploma or equivalent REQUIRED
• Strong knowledge of US healthcare insurance systems (Medicare, Medicaid, commercial payers).
• 24 years of experience in US healthcare claims processing
• Familiarity with claims management software and EDI transactions.
• Excellent analytical, organizational, and communication skills.
• Ability to interpret insurance policies and payer guidelines.
• Detail-oriented with strong problem-solving abilities.

Competencies

• Regulatory Knowledge Deep understanding of US healthcare laws and payer requirements.
• Accuracy & Detail Orientation Ensures claims are processed correctly and efficiently.
• Problem-Solving Resolves claim disputes and denials effectively.

Salary and Other Compensation

Applications will be accepted until June 5, 2026. The hourly rate for this position is between $16.00 17.00 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.

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

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.

About Cognizant

Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization's unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.

Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, provincial or local laws.

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