Process Specialist

2 weeks ago

Coimbatore India Cognizant Full time

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 - Analyze healthcare claims data to ensure accuracy and compliance with regulatory standards. - Utilize Advanced Excel skills to manage and manipulate large datasets for reporting and analysis. - Perform claims adjudication tasks to determine the validity and accuracy of claims. - Collaborate with team members to resolve discrepancies and improve claims processing efficiency. - Provide support in the development and implementation of process improvements. - Maintain up-to-date knowledge of healthcare regulations and policies. - Communicate effectively with internal and external stakeholders to address claims-related issues. - Ensure timely and accurate processing of claims to meet organizational targets. - Participate in training sessions to stay current with industry best practices. - Assist in the preparation of reports and documentation for management review. - Contribute to the continuous improvement of claims processing workflows. - Support the team in achieving performance metrics and quality standards. - Demonstrate a commitment to customer service and operational excellence. Qualifications - Possess strong technical skills in Advanced Excel for data analysis and reporting. - Have experience in claims adjudication to ensure accurate and compliant claims processing. - Knowledge of Medicare and Medicaid claims is a plus. - Familiarity with commercial claims is an added advantage. - Proficient in English with excellent reading writing and speaking skills. - Ability to work night shifts in a hybrid work model. - Strong attention to detail and problem-solving skills. - Effective communication and collaboration abilities. - Commitment to continuous learning and professional development. Certifications Required Certified Professional Coder (CPC) or equivalent certification in healthcare claims processing.

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