Medical Claims Processor - Remote

Cognizant • Montpelier, VT • 1d ago

Cognizant is a large IT Consulting Firm that leverages modern technologies to transform a variety of business operations. We are seeking Fully Remote US Based Claims Processors to join our growing team. The Medical Claims Processor is responsible for the timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client for issues related to claims adjudication and adjustments, Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the Plan Document.

Role Responsibilities

Responsible for reviewing the data in the claim processing system (Facets) and comparing it with the corresponding UB, HCFA paper, or EDI information.

Responsible for reviewing medical records when necessary to determine if the service rendered was medically appropriate and criteria has been met.

Responsible for reviewing claim and line item edits and warning messages for determination of whether to pay claim/line item(s).

Ensure that all designated tasks are handled within the appropriate timeframe in order to meet internal and external SLAs

Assigned special projects or other duties as determined by management.

Will work closely with other departments

Desired Qualifications

At least a High School Diploma or equivalent is required

A minimum of 1 years of medical claims processing is required

Facets experience is highly preferred

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 supervision.

Creative thinker with good problem-solving skills specifically related to healthcare claim adjudication

Possess the ability to work at a computer for extended periods.

Must have basic Microsoft Excel skills

Salary and Other Compensation

Applications will be accepted until August 15th, 2025.

The hourly rate for this position is between $15.20 - $17.75 per hour, depending on experience and other qualifications of the successful candidate.

This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans.

Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

Medical/Dental/Vision/Life Insurance

Paid holidays plus Paid Time Off

401(k) plan and contributions

Long-term/Short-term Disability

Paid Parental Leave

Employee Stock Purchase Plan

Disclaimer: The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

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.

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

Similar Jobs

Physical Therapist Assistant (PTA)

BAYADA Home Health Care • Montpelier, VT • 1d ago

Hospital & Medical

**$7,500 Retention Bonus Available BAYADA Home Health Care** is currently seeking an experienced Physical Therapist Assistant (PTA) to perform home health visits for our office located in South Burlington, VT. This posit...

1d ago

Go to Apply

Physical Therapist, Home Health

BAYADA Home Health Care • Montpelier, VT • 1d ago

Hospital & Medical

BAYADA Home Health Care is currently seeking an experienced Physical Therapist, PT, for a full-time opportunity performing home health visits for our visits office, located in Williston, VT . This office services adult a...

1d ago

Go to Apply

Phlebotomist

Health Advocates Network • Berlin, VT • 1d ago

Hospital & Medical

Benefits We Offer: Comprehensive health, prescription, dental, vision, life, and disability plans Competitive pay rates Referral opportunities ? Refer a friend & Cash in! Travel reimbursement and per diem allowances...

1d ago

Go to Apply

Oracle Health Federal Customer Service Administrator

Oracle • Montpelier, VT • 3d ago

Hospital & Medical

Job Description We're on a journey to advance how health happens with technologies that empower patients, support clinicians, inspire innovation, and save lives. Our mission? To create a human-centric healthcare experien...

3d ago

Go to Apply

Health Information Specialist 1

Datavant • Montpelier, VT • 4d ago

Hospital & Medical

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is power...

4d ago

Go to Apply

Health Information Specialist I - Temporary

Datavant • Montpelier, VT • 5d ago

Hospital & Medical

5d ago

Go to Apply

Clinical Strategy Lead

Humana • Montpelier, VT • 1w ago

Hospital & Medical

Become a part of our caring community and help us put health first The Clinical Strategy Team is a multi-disciplinary team focused on using data analysis and clinical acumen to build strategies that improve experiences f...

1w ago

Go to Apply

Mental Health Scheduling Coordinator - Temporary

State of Vermont • Barre, VT • 1w ago

Hospital & Medical

This job was posted by https://www.vermontjoblink.com : For more information, please see: https://www.vermontjoblink.com/jobs/1285540 Overview The Mental Health Scheduling Coordinator position provides coverage in the St...

1w ago

Go to Apply

Field Medical Director-Vascular Surgery

Evolent • Montpelier, VT • 1w ago

Hospital & Medical

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to conn...

1w ago

Go to Apply

Clinical Scientist - PART TIME - P1425266BOSJB_35-4658

Beacon Hill Staffing Group, LLC • Montpelier, VT • 1w ago

Hospital & Medical

This job was posted by https://www.vermontjoblink.com : For more information, please see: https://www.vermontjoblink.com/jobs/1285457 Beacon Hill was founded to set a new standard in search, career placement and flexible...

1w ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.