Medical Claims Processor - Remote

Fully Remote US Based Medical Claims Processor

Cognizant is a large IT Consulting Firm that leverages modern technologies to transform a variety of business operations. We are seeking Fully Remote US Based Claims Processors to join our growing team. The Medical Claims Processor is responsible for the timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client for issues related to claims adjudication and adjustments, Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the Plan Document.

Role Responsibilities :

• Responsible for reviewing the data in the claim processing system (Facets) and comparing it with the corresponding UB, HCFA paper, or EDI information.
• Responsible for reviewing medical records when necessary to determine if the service rendered was medically appropriate and criteria has been met.
• Responsible for reviewing claim and line item edits and warning messages for determination of whether to pay claim / line item(s).
• Ensure that all designated tasks are handled within the appropriate timeframe in order to meet internal and external SLAs.
• Assigned special projects or other duties as determined by management.
• Will work closely with other departments.

Desired Qualifications :

Salary and Other Compensation :

Applications will be accepted until October 31st, 2025. The hourly rate for this position is between $13 $17.75 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 :

Disclaimer : The hourly rate, 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 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. 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.