Process Specialist - HC

Cognizant; Coimbatore; Hybrid; USD 3,408 - 5,680; Full time

Job summary

An established industry player is looking for a Process Specialist in their Healthcare division. This entry-level role offers an exciting opportunity to work with healthcare claims processing in a hybrid model, including night shifts. The ideal candidate will leverage their Advanced Excel skills and claims adjudication experience to analyze data, ensure compliance, and contribute to process improvements. This position promises a dynamic work environment where you can develop your skills and grow your career in the healthcare sector. Join a team dedicated to operational excellence and customer service while making a real impact in the healthcare industry.

Qualifications

• Strong technical skills in Advanced Excel for data analysis and reporting.
• Experience in claims adjudication to ensure accurate claims processing.

Responsibilities

• Analyze healthcare claims data for accuracy and compliance.
• Utilize Advanced Excel to manage large datasets for reporting.

Skills

Advanced Excel

Claims Adjudication

Problem-solving

Communication

Education

Certified Professional Coder (CPC)

Job description

Job Summary

We are seeking a Process Specialist for our Healthcare division with 0 to 1 year of experience. The ideal candidate will have expertise in Advanced Excel and Claims Adjudication. This role involves working in a hybrid model with night shifts. The candidate should be proficient in English and have a keen interest in healthcare claims processing.

Responsibilities

1. Analyze healthcare claims data to ensure accuracy and compliance with regulatory standards.
2. Utilize Advanced Excel skills to manage and manipulate large datasets for reporting and analysis.
3. Perform claims adjudication tasks to determine the validity and accuracy of claims.
4. Collaborate with team members to resolve discrepancies and improve claims processing efficiency.
5. Provide support in the development and implementation of process improvements.
6. Maintain up-to-date knowledge of healthcare regulations and policies.
7. Communicate effectively with internal and external stakeholders to address claims-related issues.
8. Ensure timely and accurate processing of claims to meet organizational targets.
9. Participate in training sessions to stay current with industry best practices.
10. Assist in the preparation of reports and documentation for management review.
11. Contribute to the continuous improvement of claims processing workflows.
12. Support the team in achieving performance metrics and quality standards.
13. Demonstrate a commitment to customer service and operational excellence.

Qualifications

1. Possess strong technical skills in Advanced Excel for data analysis and reporting.
2. Have experience in claims adjudication to ensure accurate and compliant claims processing.
3. Knowledge of Medicare and Medicaid claims is a plus.
4. Familiarity with commercial claims is an added advantage.
5. Proficient in English with excellent reading, writing, and speaking skills.
6. Ability to work night shifts in a hybrid work model.
7. Strong attention to detail and problem-solving skills.
8. Effective communication and collaboration abilities.
9. Commitment to continuous learning and professional development.

Certifications Required

Certified Professional Coder (CPC) or equivalent certification in healthcare claims processing.