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On-site

Job Type

Full Time

Job Description

Job Summary

Claims Adjudication

Responsibilities

  • Process claims using ClaimsExchange and Facets ensuring accuracy and compliance with company standards.
  • Collaborate with team members to resolve any discrepancies or issues related to claims processing.
  • Maintain up-to-date knowledge of industry regulations and company policies to ensure compliance.
  • Provide timely and accurate responses to inquiries from internal and external stakeholders.
  • Analyze claims data to identify trends and areas for improvement in processing efficiency.
  • Assist in the development and implementation of process improvements to enhance claims processing.
  • Participate in training sessions to stay informed about new technologies and procedures.
  • Support the team in meeting departmental goals and objectives through effective claims management.
  • Communicate effectively with team members and management to ensure smooth workflow.
  • Utilize problem-solving skills to address and resolve claims-related issues promptly.
  • Ensure all claims are processed within the designated timeframes to meet service level agreements.
  • Contribute to the overall success of the claims department by maintaining a high level of accuracy and efficiency.
  • Engage in continuous learning to enhance skills and knowledge in claims processing. Qualifications
  • Demonstrate proficiency in using ClaimsExchange and Facets for claims processing.
  • Possess a basic understanding of Medicare and Medicaid claims processes.
  • Exhibit strong analytical skills to identify and resolve claims discrepancies.
  • Show effective communication skills for interacting with team members and stakeholders.
  • Display a keen attention to detail to ensure accuracy in claims processing.
  • Have a willingness to work night shifts in an office environment.
  • Be eager to learn and grow in the field of claims processing.

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Cognizant

IT Services and IT Consulting

Teaneck New Jersey

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