This is a 100% remote position (Work From Home). 

Job description:

• Pay or deny claims according to the benefit summary


• Review membership eligibility for determination


• Assign correct provider for proper payment


• Follow all HIPA guidelines


• Review member’s out of pocket for correct cost share application


• Review COB information and apply it accordingly


• Review Error codes, warning messages and edits for correct processing


• Analyze claims for correct payment verification and adjust where needed


• Use of the Facets system to adjudicate claims

Preferred experience:

• Priority will be given to those with knowledge of the Facets systems and application


• Knowledge of Medicaid, Medicare or commercial claims processing


• COB and benefit summary knowledge

Required:

• High school diploma or GED


• Experience with claims or customer service in medical field


• Ability to work independently and with others in a fast pace production based environment


• Basic Excel skills

Cognizant will only consider applicants for this position whom are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.

Domain Skills

* Proficiency Legends