Claims Adjudicator (remote)

Claims Adjudicator (Remote)

We are seeking a Claims Adjudicator to work remotely with 1 to 2 years of experience in Claims Adjudication. The ideal candidate will have a good understanding in Medicare, Medicaid Claims, Appeals and Grievances, and Commercial Claims. With a focus on accuracy and timeliness you will utilize your expertise in MS Excel to analyze data and support the claims process. This remote role offers a balanced work environment allowing you to contribute effectively while maintaining a healthy work-life balance.

Responsibilities

Analyze and process claims with precision to ensure timely resolution and customer satisfaction.

Utilize MS Excel to manage and interpret data enhancing the efficiency of claims processing.

Collaborate with team members to identify trends and patterns in claims data for continuous improvement.

Communicate effectively with stakeholders to provide updates and resolve any issues related to claims.

Ensure compliance with company policies and industry regulations throughout the claims process.

Support the appeals and grievances process by providing accurate data and insights.

Contribute to the development of process improvements to streamline claims operations.

Maintain accurate records and documentation for all claims activities.

Assist in training new team members on claims processes and best practices.

Participate in regular team meetings to discuss progress and share insights.

Provide exceptional customer service by addressing inquiries and concerns promptly.

Monitor and report on key performance indicators related to claims processing.

Adapt to changing priorities and work effectively in a fast-paced environment.

Qualifications

High School Diploma Required

Should have at least 2 years of experience in the medical field, either through work or volunteer roles.

Experience in claims hospital and professional claims adjudication is mandatory.

Experience in other clinical services search program management and health records is an added advantage.

A strong understanding of Claims, Appeals and Medical Benefits

Proficiency in computer skills including typing speed and accuracy

Good written and verbal communication skills

Ability to maintain a high level of integrity and confidentiality of medical information

Salary and Other Compensation

Applications will be accepted until October 24th, 2025. The annual salary for this position is between $16.00 - $17.00 depending on the experience and other qualifications of the successful candidate. This position is also eligible for Cognizant's discretionary annual incentive program and stock awards, 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

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.