Hybrid Claims Adjudicator en Cognizant

%3Cdiv%3E%3Cstrong%3EHybrid Claims Adjudicator- Winston Salem, NC%3C/strong%3E%3C/div%3E%3Cp%3E%3Cstrong%3EOverview:%3C/strong%3E%3C/p%3E%3Cp%3EWe are seeking a Claims Adjudicator in Winston Salem, North Carolina with 1 to 2 years of experience in Claims Adjudication. %3Ci%3ETraining will be 4-6 weeks In-Office, then this role will be 100% remote%3C/i%3E. 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 hybrid role offers a balanced work environment allowing you to contribute effectively while maintaining a healthy work-life balance.%3C/p%3E%3Cp%3E%3Cstrong%3EResponsibilities:%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3EAnalyze and process claims with precision to ensure timely resolution and customer satisfaction.%3C/li%3E%3Cli%3EUtilize MS Excel to manage and interpret data enhancing the efficiency of claims processing.%3C/li%3E%3Cli%3ECollaborate with team members to identify trends and patterns in claims data for continuous improvement.%3C/li%3E%3Cli%3ECommunicate effectively with stakeholders to provide updates and resolve any issues related to claims.%3C/li%3E%3Cli%3EEnsure compliance with company policies and industry regulations throughout the claims process.%3C/li%3E%3Cli%3ESupport the appeals and grievances process by providing accurate data and insights.%3C/li%3E%3Cli%3EContribute to the development of process improvements to streamline claims operations.%3C/li%3E%3Cli%3EMaintain accurate records and documentation for all claims activities.%3C/li%3E%3Cli%3EAssist in training new team members on claims processes and best practices.%3C/li%3E%3Cli%3EParticipate in regular team meetings to discuss progress and share insights.%3C/li%3E%3Cli%3EProvide exceptional customer service by addressing inquiries and concerns promptly.%3C/li%3E%3Cli%3EMonitor and report on key performance indicators related to claims processing.%3C/li%3E%3Cli%3EAdapt to changing priorities and work effectively in a fast-paced environment.%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EQualifications:%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3EHigh School Diploma%3Cstrong%3E Required%3C/strong%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22line-height:normal;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;tab-stops:list .5in;%22%3EShould have at least 2 years of experience in the medical field, either through work or volunteer roles.%3Co:p%3E%3C/o:p%3E%3Cul%3E%3Cli class=%22MsoNormal%22 style=%22line-height:normal;mso-list:l0 level2 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;tab-stops:list 1.0in;%22%3EFACETS experience is an added advantage%3Co:p%3E%3C/o:p%3E%3C/li%3E%3C/ul%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22line-height:normal;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;tab-stops:list .5in;%22%3EExperience in claims hospital and professional claims adjudication is mandatory.%3Co:p%3E%3C/o:p%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22line-height:normal;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;tab-stops:list .5in;%22%3EExperience in other clinical services search program management and health records is an added advantage.%3Co:p%3E%3C/o:p%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22line-height:normal;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;tab-stops:list .5in;%22%3EA strong understanding of Claims, Appeals and Medical Benefits%3Co:p%3E%3C/o:p%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22line-height:normal;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;tab-stops:list .5in;%22%3EProficiency in computer skills including typing speed and accuracy%3Co:p%3E%3C/o:p%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22line-height:normal;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;tab-stops:list .5in;%22%3EGood written and verbal communication skills%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22line-height:normal;mso-list:l0 level1 lfo1;mso-margin-bottom-alt:auto;mso-margin-top-alt:auto;tab-stops:list .5in;%22%3EAbility to maintain a high level of integrity and confidentiality of medical information%3C/li%3E%3C/ul%3E%3Cp%3E%26nbsp;%3C/p%3E%3Cp%3E%3Cbr%3E%26nbsp;%3C/p%3E%3Cp%3E%26nbsp;%3C/p%3E Solicitar ahora