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At Cognizant, we're not just about technology; we're about pioneering solutions that create meaningful transformations. We're looking for innovative minds, problem-solvers who are passionate about making a difference in the fast-paced world of technology. If you're ready to challenge the status quo and drive excellence, we want you on our team.
Purpose:Claim processors will review claim submissions, verify information, adjudicate the claim as per claim processing guidelines to ensure appropriate payment or denial as per the business requirements.
Essential functions:1. Examining and entering 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 met
2. Processing 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 benefit
3. Approving, pending, or denying payment according to the accepted coverage guidelines
4. Follows all team procedures, including HIPAA policies and procedures, and meets team quality, turnaround time and productivity performance standards and goals
5. Identifying and referring all claims with potential third party liability (i.e.,. subrogation, COB, MVA, stop loss claims, and potential stop loss files)
6. Maintaining 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 payments
7. Other duties as assigned
8. Must be willing to work overtime when the business need requires
Qualifications:Education: High School diploma or GED required.
Experience: Minium of two-three years of Medicaid and or Commercial claims payer processing experience.
Technical Compentencies:9. Ability to work independently
10. Strong attention to detail
11. Strong interpersonal, time management and organizational skills
12. Good oral/written communication and analytical skills
13. Must be able to work in a high performance environment that changes often
14. Experience in navigating multiple systems using dual monitors
15. Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes, and standard of billing guidelines required.
16. FACETS experience (highly preferred)
17. Medicaid knowledge (required)
18. Keyboard skills of at least 35 WPM 10-key
19. Proficient in Microsoft Office - Excel, Word, and Outlook
20. Healthacre claims payer processing experience (required)
21. Ability to work in a high pace while maintaining quality and productivity targets
Working Enviornment Requirement:22. Ability to work remotely in a secure environment (required)
23. Must have high-speed internet connection (required)
24. Must have highs-speed internet modem with ability to connect laptop to wired connection port (Required)
25. Must have a workspace and location free from distractions and safety of healthcare data (required)
Location: Fully Remote Salary and Other Compensation:The hourly rate for this position is $17-20, dependent 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:
Disclaimer: The salary, 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.
The Cognizant community:We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive.
Cognizant (Nasdaq-100: CTSH) is one of the world's leading professional services companies, helping organizations modernize technology, reimagine processes and transform experiences, so they stay ahead in a fast-changing world.
Our commitment to diversity and inclusion:Cognizant is an equal opportunity employer that embraces diversity, champions equity and values inclusion. We are dedicated to nurturing a community where everyone feels heard, accepted and welcome. 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 protected characteristic as outlined by federal, state or local laws.
Disclaimer:Compensation 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.
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.
Full Time
IT Outsourcing & Consulting
$39k-47k (estimate)
06/26/2024
08/24/2024
cognizant.com
TEANECK, NJ
>50,000
1998
BRIAN HUMPHRIES
$10B - $50B
IT Outsourcing & Consulting
Cognizant (Nasdaq-100: CTSH) is one of the world's leading professional services companies, transforming clients' business, operating and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant is ranked 194 on the Fortune 500 and is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com or follow us @Cognizant.
The job skills required for Medical Claims Processor (Remote) include Claim Processing, Microsoft Office, Billing, Written Communication, Attention to Detail, CPT, etc. Having related job skills and expertise will give you an advantage when applying to be a Medical Claims Processor (Remote). That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Medical Claims Processor (Remote). Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Medical Claims Processor (Remote) positions, which can be used as a reference in future career path planning. As a Medical Claims Processor (Remote), it can be promoted into senior positions as a Claims Clerk II that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Medical Claims Processor (Remote). You can explore the career advancement for a Medical Claims Processor (Remote) below and select your interested title to get hiring information.