Claims Processor with Facets

Cognizant Technology Solutions Corporation; United States; Remote; USD 45,000 - 60,000; Full time

Job summary

A leading healthcare solutions provider is seeking a Claims Processor (with Facets) to work remotely. The role involves reviewing claim system data, evaluating medical records, and managing tasks to meet service deadlines. Candidates must have at least 2 years of claims processing experience and knowledge of medical terminology and coding. This is an excellent opportunity for skilled professionals looking to advance their careers in a supportive environment.

Qualifications

• Minimum of 2 years' claims processing experience required.
• Knowledge of medical terminology and coding is essential.
• Experience with UB/institutional and/or professional claims is a must.

Responsibilities

• Review claim system data and verify against UB or HCFA information.
• Evaluate medical records for service appropriateness.
• Manage tasks to meet internal and external SLAs.

Skills

Claims processing

Medical terminology

Coding knowledge

Facets experience

Education

High School degree or GED

Job description

A company is looking for a Claims Processor (with Facets) - Healthcare Remote.

Key Responsibilities

• Review claim system data and verify against UB or HCFA paper or EDI information
• Evaluate medical records for service appropriateness and compliance with criteria
• Manage all tasks within designated timelines to meet internal and external SLAs

Required Qualifications

• A minimum of 2 years' claims processing experience
• Knowledge of physician practice and hospital coding, and medical terminology (CPT, HCPCA, ICD-10)
• Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims
• 1 year of Facets experience
• High School degree or GED or equivalent experience