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If you want to be in the medical claims and billing field and work from home this blog post is just for you. Cognizant is hiring for a medical claims processor, fulltime and remote. They don’t require any college degree and are hiring for the full time day shift. This is a remote position open to any qualified applicant in the United States.

Job Overview:

This position will be responsible for timely and accurate adjudication of professional and hospital claims using payer specific policies and procedures. You will provide support to claims and clients for issues related to claims adjudication and adjustments, Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the employer's Plan Document.

Responsibilities:

  • Review the data in the claim processing system, and compare with corresponding UB or HCFA paper or EDI information.
  • Review medical records when necessary to determine if service rendered was medically appropriate and criteria has been met.
  • Review claim and line item edits and warning messages for determination of whether to pay claim/line item(s).
  • Ensuring all designated tasks are handled within the appropriate timeframe in order to meet internal and external SLAs
  • Assigning special projects or other duties as determined by management.
  • Possess ability to work at a computer for extended periods.

Qualifications:

  • A minimum of 1 years claims processing
  • High School degree or GED or equivalent experience.
  • Knowledge of physician practice and hospital coding, billing and medical terminology, CPT, HCPCS, ICD-9
  • Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims
  • Knowledge of Medicare billing & payment and coverage guidelines and regulations
  • Experience in the analysis and processing of claims, utilization review/quality assurance procedures
  • Must be able to work with minimal direction.
  • Creative thinker with good skills to resolve problems specifically related to healthcare claim adjudication
  • Will work closely with other departments


Cognizant will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.

You can Apply Here 



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