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PE-Claims HC

Cognizant

0 years

0 Lacs

Coimbatore, Tamil Nadu

Posted:3 weeks ago| Platform: SimplyHired logo

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Skills Required

Communication skills

Work Mode

On-site

Job Type

Full Time

Job Description

Job Summary

Join our dynamic team as a PE-Claims HC specialist where you will play a crucial role in processing and adjudicating claims with precision and efficiency. This hybrid role offers the opportunity to work with Medicare and Medicaid claims ensuring compliance and accuracy. With a focus on night shifts you will contribute to our mission of delivering exceptional healthcare services.

Responsibilities

Process and adjudicate claims with a focus on accuracy and compliance ensuring timely resolution.
Collaborate with team members to review and analyze Medicare and Medicaid claims identifying discrepancies and resolving issues.
Utilize technical skills in claims adjudication to streamline processes and enhance efficiency.
Maintain up-to-date knowledge of industry regulations and standards to ensure compliance in all claims processing activities.
Communicate effectively with internal and external stakeholders to facilitate smooth claims processing and resolution.
Monitor and report on claims processing metrics identifying areas for improvement and implementing solutions.
Provide support and guidance to team members fostering a collaborative and productive work environment.
Participate in training sessions and workshops to enhance skills and stay informed about industry trends.
Contribute to the development and implementation of best practices for claims processing and adjudication.
Ensure all claims are processed in accordance with company policies and procedures maintaining high standards of quality.
Assist in the preparation of reports and documentation related to claims processing activities.
Engage in continuous learning and development to enhance technical and domain expertise.
Support the companys mission by delivering exceptional service and contributing to the overall success of the healthcare claims department.

Qualifications

Demonstrate proficiency in claims adjudication with a strong understanding of Medicare and Medicaid claims.
Possess excellent analytical and problem-solving skills to identify and resolve claims discrepancies.
Exhibit strong communication skills to effectively interact with team members and stakeholders.
Show a commitment to continuous learning and professional development in the healthcare claims domain.
Display attention to detail and accuracy in all aspects of claims processing.
Have the ability to work independently and collaboratively in a hybrid work model.
Be adaptable to night shift work ensuring consistent performance and productivity.

Certifications Required

N / A

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PE-Claims HC