SPE-Claims HC | Overnight Jobs HQ
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Cognizant Technology Solutions

SPE-Claims HC

Cognizant Technology Solutions

Healthcare Night Shift Full-time

Job Description

Job Summary

We are seeking a skilled SPE-Claims HC professional with 2 to 4 years of experience in healthcare products. The ideal candidate will have expertise in commercial insurance enrollment and Medicare enrollment. This work-from-home position requires proficiency in English and involves night shifts. The role focuses on ensuring efficient claims processing and contributing to the companys mission of improving healthcare accessibility.


Responsibilities

  • Oversee the claims processing workflow to ensure timely and accurate handling of healthcare claims.
  • Collaborate with team members to resolve complex issues related to commercial insurance enrollment.
  • Analyze Medicare enrollment data to identify trends and improve service delivery.
  • Provide expert guidance on healthcare product features to enhance customer satisfaction.
  • Develop and implement strategies to streamline claims processing and reduce turnaround time.
  • Ensure compliance with industry regulations and company policies in all claims-related activities.
  • Utilize advanced analytical skills to assess and improve claims processing efficiency.
  • Communicate effectively with stakeholders to address and resolve claims-related inquiries.
  • Maintain up-to-date knowledge of healthcare products and industry trends to support informed decision-making.
  • Contribute to the development of training materials for new team members to ensure consistent service quality.
  • Monitor and report on key performance indicators to drive continuous improvement in claims processing.
  • Support the implementation of new technologies to enhance claims management capabilities.
  • Collaborate with cross-functional teams to align claims processing with overall business objectives. Qualifications
  • Possess strong analytical skills to evaluate and improve claims processes.
  • Demonstrate proficiency in healthcare product knowledge and application.
  • Exhibit excellent communication skills in English for effective stakeholder interaction.
  • Have a deep understanding of commercial insurance and Medicare enrollment procedures.
  • Show ability to work independently in a remote setting and manage night shift responsibilities.
  • Display a commitment to maintaining compliance with industry standards and regulations.


Certifications Required

Certified Professional in Healthcare Management (CPHM)

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