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Work Mode

On-site

Job Type

Full Time

Job Description

Job Summary

The TL-Encounters role is pivotal in ensuring the seamless processing and adjudication of claims within our hybrid work model. With a focus on Facets and UiPath the candidate will leverage their expertise in Provider and Payer domains to optimize workflows and enhance operational efficiency. This night shift position requires a proactive approach to problem-solving and a commitment to delivering high-quality results.

Responsibilities

  • Lead the team in the efficient processing of claims using Facets to ensure accuracy and compliance.
  • Oversee the automation of routine tasks through UiPath to enhance productivity and reduce manual errors.
  • Provide expert guidance on claims adjudication processes to ensure timely and accurate settlements.
  • Collaborate with cross-functional teams to streamline workflows and improve overall service delivery.
  • Analyze and resolve complex issues related to Provider and Payer domains to support business objectives.
  • Develop and implement strategies to optimize claims processing and reduce turnaround times.
  • Monitor system performance and identify opportunities for improvement to enhance operational efficiency.
  • Ensure adherence to industry regulations and company policies in all claims processing activities.
  • Facilitate training sessions to upskill team members on the latest tools and technologies.
  • Conduct regular audits to maintain data integrity and compliance with established standards.
  • Communicate effectively with stakeholders to provide updates on project progress and challenges.
  • Drive continuous improvement initiatives to foster innovation and excellence within the team.
  • Support the development of best practices and standard operating procedures to ensure consistency.

Qualifications

  • Possess strong technical skills in Facets and UiPath essential for optimizing claims processing.
  • Demonstrate expertise in claims adjudication crucial for accurate and timely settlements.
  • Have in-depth knowledge of Provider and Payer domains vital for understanding industry dynamics.
  • Exhibit excellent problem-solving abilities necessary for resolving complex issues.
  • Show proficiency in automation tools important for enhancing operational efficiency.
  • Display strong communication skills essential for effective stakeholder engagement.
  • Maintain a proactive approach to learning and adapting to new technologies and methodologies.

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Cognizant

IT Services and IT Consulting

Teaneck New Jersey

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