Healthcare Facets Encounter Claims Consultant

Cognizant North America; Cincinnati (OH); Remote; USD 82,000 - 105,000; Full time

Job summary

An established industry player is seeking a Claims Encounters Consultant to provide expertise in EDI files and ensure accurate submission of encounter data. This role is crucial in maintaining compliance with standards and improving processes. The ideal candidate will have significant healthcare experience, particularly in EDI implementation, and a strong understanding of data analysis. This remote position offers a competitive salary and a comprehensive benefits package, making it an exciting opportunity for those passionate about transforming healthcare processes.

Benefits

Medical/Dental/Vision/Life Insurance

Paid Time Off

401(k) plan

Long-term/Short-term Disability

Paid Parental Leave

Employee Stock Purchase Plan

Qualifications

• 10 years of healthcare experience with 5 years in EDI implementation.
• Strong understanding of EDI standards and encounter data formats.

Responsibilities

• Ensure accurate and timely submission of encounter data.
• Analyze encounter data to identify trends and areas for improvement.

Skills

Healthcare Experience

EDI Implementation

Data Analysis

Problem-Solving Skills

Attention to Detail

Communication Skills

Tools

FACETS Claims Module

Job description

About Us:

Cognizant (Nasdaq: CTSH) is one of the world's leading professional services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build, and run more innovative and efficient businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life.

Job Summary:

The Claims Encounters Consultant is responsible for providing customers with application domain expertise related to EDI files like 837P,837I,837D and few other types. This role involves in ensuring accurate and timely submission of encounters for varies markets. The position requires excellent general consulting and EDI skills and is remote participation.

Job Title: Facets Claims Encounter Consultant

Location: Remote

Job ID: SO# 00062542311

The Role: Individual Contributor External Facing Role

Role and Responsibilities:

• Ensuring accurate and timely submission of encounter data.
• Maintaining the accuracy and completeness of encounter data, including member information, service dates, and procedure codes.
• Identifying and resolving encounter rejections, often related to claims data or eligibility
• Adhering to compliance standards and regulatory requirements for encounter data submissions.
• Developing and implementing business processes to improve encounter acceptance rates and streamline submissions.
• Analyzing encounter data to identify trends, patterns, and areas for improvement.
• Communicating with vendors, internal stakeholders, and payers to ensure successful implementation and address issues.

Required Experience:

• 10 years of healthcare experience, with 5 years of recent and relevant EDI implementation.
• Strong understanding of EDI standards and encounter data formats.
• Strong Experience on FACETS - Claims module.
• Experience with encounter data submissions and resolution.
• Knowledge of healthcare billing and coding regulations.
• Data analysis and problem-solving skills.
• Attention to detail and accuracy
• Communication and interpersonal skills.

Salary and Other Compensation:

Applicants will be accepted till 5/21/2025

The annual salary for this position will be in the range of $82K-$105K depending on the 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 salary, 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.

Our strength is built on our ability to work together. Our diverse backgrounds offer different perspectives and new ways of thinking. It encourages lively discussions, creativity, productivity, and helps us build better solutions for our clients. We want someone who thrives in this setting and is inspired to craft meaningful solutions through true collaboration.

If you are content with ambiguity, excited by change, and excel through autonomy, we'd love to hear from you!

Apply Now!