Job Summary

We are seeking a skilled Claims Adjudication Specialist with 3 to 5 years of experience to join our team. The ideal candidate will have a strong background in claims adjudication processes and a keen eye for detail. This work-from-home position requires a proactive individual who can efficiently manage claims and contribute to our companys success in the healthcare sector. The role is crucial in ensuring accurate and timely claims processing ultimately benefiting our clients and the broader co

Responsibilities

• Review and analyze claims to ensure accuracy and compliance with established guidelines.
• Process claims efficiently ensuring timely adjudication and resolution.
• Collaborate with team members to identify and resolve discrepancies in claims data.
• Utilize claims adjudication software to manage and track claims processing.
• Communicate effectively with stakeholders to provide updates on claims status.
• Identify trends and patterns in claims data to improve processing efficiency.
• Ensure adherence to regulatory requirements and company policies in all claims activities.
• Provide support and guidance to team members on complex claims issues.
• Maintain accurate records of claims processing activities for audit purposes.
• Contribute to the development of process improvements to enhance claims adjudication.
• Participate in training sessions to stay updated on industry changes and best practices.
• Engage in continuous learning to enhance skills and knowledge in claims adjudication.
• Support the companys mission by ensuring high-quality claims processing that meets client needs.

Qualifications

• Possess strong analytical skills to evaluate and process claims accurately.
• Demonstrate proficiency in using claims adjudication software and tools.
• Exhibit excellent communication skills to interact with stakeholders effectively.
• Have a keen attention to detail to identify and resolve claims discrepancies.
• Show a proactive approach to problem-solving in claims processing.
• Display a solid understanding of healthcare claims and related regulations.
• Possess the ability to work independently in a remote work environment.

Certifications Required

Certified Professional Coder (CPC) or equivalent certification in claims adjudication.

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 is a global community with more than 300,000 associates around the world.
• We don’t just dream of a better way – we make it happen.
• We take care of our people, clients, company, communities and climate by doing what’s right.
• We foster an innovative environment where you can build the career path that’s right for you.

About us:
Cognizant 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 (a member of the NASDAQ-100 and one of Forbes World’s Best Employers 2025) is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com

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, state or local laws.

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

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.