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SPE-Claims HC

Cognizant

1 - 3 years

0 Lacs

Coimbatore, Tamil Nadu

Posted:1 month ago| Platform: SimplyHired logo

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Skills Required

Analysis skills

Work Mode

On-site

Job Type

Full Time

Job Description

Job Summary

We are seeking a skilled Claims Adjudication Specialist with 1 to 3 years of experience to join our team. The role involves working from the office during night shifts focusing on claims adjudication processes. The ideal candidate will have a strong understanding of claims and payer domains contributing to efficient and accurate claims processing enhancing our service delivery.

Responsibilities

Process claims efficiently and accurately to ensure timely adjudication and resolution.
Collaborate with team members to identify and resolve discrepancies in claims processing.
Analyze claims data to identify trends and areas for improvement in adjudication processes.
Maintain up-to-date knowledge of industry standards and regulations related to claims adjudication.
Communicate effectively with internal and external stakeholders to address claims-related inquiries.
Utilize technical skills to enhance the accuracy and efficiency of claims processing.
Implement best practices in claims adjudication to improve overall service quality.
Monitor claims processing metrics to ensure compliance with performance standards.
Provide feedback and suggestions for process improvements to enhance operational efficiency.
Ensure all claims are processed in accordance with company policies and procedures.
Support the team in achieving departmental goals and objectives through effective claims management.
Participate in training sessions to stay updated on new technologies and methodologies in claims adjudication.
Contribute to the development of a positive work environment by fostering teamwork and collaboration.

Qualifications

Demonstrate proficiency in claims adjudication with a strong technical background.
Exhibit knowledge of claims and payer domains to enhance processing accuracy.
Possess excellent analytical skills to identify and resolve claims discrepancies.
Show ability to communicate effectively with stakeholders at all levels.
Display commitment to maintaining up-to-date industry knowledge.
Demonstrate problem-solving skills to improve claims processing efficiency.
Exhibit teamwork and collaboration skills to support departmental objectives.

Certifications Required

Certified Claims Professional (CCP) or equivalent certification in claims adjudication.

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SPE-Claims HC