SPE-Claims HC
Cognizant Technology Solutions
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)