Senior Process Executive-Data Senior Process Executive-Data …

Cognizant
in Tampa, FL, United States
Permanent, Full time
Be the first to apply
Competitive
Cognizant
in Tampa, FL, United States
Permanent, Full time
Be the first to apply
Competitive
Senior Process Executive-Data
SPE Claims Processor
Qualification:
"Cognizant will only consider applicants for this position whom are legally authorized to work in the United States without company sponsorship (H-1B, L-1B, L-1A, etc.).”

Job description:
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  • Pay or deny claims according to the benefit summary
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  • Review membership eligibility for determination
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  • Assign correct provider for proper payment
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  • Follow all HIPA guidelines
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  • Review member's out of pocket for correct cost share application
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  • Review COB information and apply it accordingly
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  • Review Error codes, warning messages and edits for correct processing
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  • Analyze claims for correct payment verification and adjust where needed
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  • Use of the Facets system to adjudicate claims
Preferred experience:
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  • Priority will be given to those with knowledge of the Facets systems and application

Required:
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  • High school diploma or GED
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  • Ability to work independently and with others in a fast pace production based environment
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  • A minimum of 4 years processing experience or degree/certification in Medicaid, Medicare or commercial claims
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  • Knowledge of COB and benefit summary
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  • Basic Excel skills


Good To Have Skills
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  • Claims
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