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Cognizant
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SPE-Claims HC

SPE-Claims HC

Cognizant

2 - 4 years

0 Lacs

Chennai Tamil Nadu India

Posted:2 days ago| Platform:

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Skills Required

healthcare enrollment processing workflow resolve analyze data service strategies compliance regulations support development training report drive management communication certifications

Work Mode

Remote

Job Type

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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SPE-Claims HC