Claims Quality Review (remote)

Cognizant; Winston-Salem (NC); Remote; USD 10,000 - 60,000; Full time

Job summary

A leading IT services company is seeking a Claims Quality Reviewer for a remote position. Responsibilities include monitoring and evaluating transactions against quality assurance standards, providing coaching, and generating reports on key metrics. Candidates must have a high school diploma and at least three years of QA experience along with five years in healthcare claims processing. Competitive hourly rate and comprehensive benefits are offered.

Benefits

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

Qualifications

• Minimum of three years QA experience.
• Minimum of five years healthcare claims processing experience.
• Excellent communication skills.

Responsibilities

• Monitor and evaluate transactions against quality assurance standards.
• Conduct coaching and feedback sessions as needed.
• Provide accurate reports on quality metrics.

Skills

Good Spoken & Written English

Coaching skills

High Attention to detail

Proficiency in Excel

Integrity and Ethical Behavior

Education

High school Diploma

Tools

MS Office applications

Job description

Overview

Claims Quality Review (remote)

This is a remote position open to any qualified applicant that lives in the United States.

Responsibilities

• Monitor, evaluate and score transactions against established quality assurance instruments and standards
• Participate, as needed, in calibration sessions, communication sessions, and/or creation of communication tools
• Supports and communicates business goals, quality standards, processes and procedures and policies
• Ensures the claims processing reps adhere to predetermined quality assurance standards and the business’s standard operating procedures, serves as Subject Matter Expert
• Conduct coaching and feedback sessions as needed
• Provides accurate and timely reports on a daily, monthly, month-to-date and year-to-date rolling basis on quality, productivity, availability and other key metrics as determined
• Ability to work overtime and/or a flexible schedule based on business, client and/or accounting needs.
• Other duties as assigned.

Qualifications

• High school Diploma - REQUIRED
• Minimum of one (3) years QA Experience
• Minimum of one (5) years Healthcare claims processing experience
• Good Spoken & Written English Good Communication Skills
• Coaching (Soft) skills
• Excel knowledge on charts & tables Knowledge on MS Office applications
• High Attention to detail
• High Level of Integrity and Ethical Behavior

Salary and Other Compensation

The hourly rate for this position is between $19.00 – 20.00 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

• 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.