SPE-Claims HC

4 days ago

Coimbatore India Cognizant Full time

Job Description Job Summary We are seeking a skilled professional with 2 to 4 years of experience in Claims Adjudication for the role of SPE-Claims HC. The ideal candidate will work from our office during night shifts focusing on ensuring accurate and efficient claims processing. Experience in Commercial Claims is a plus contributing to the enhancement of our claims management system. Responsibilities - Oversee the claims adjudication process to ensure accuracy and compliance with company standards. - Analyze claims data to identify trends and areas for improvement in claims processing. - Collaborate with team members to streamline claims workflows and enhance efficiency. - Provide insights and recommendations to improve the claims adjudication system. - Ensure all claims are processed within the stipulated time frames to maintain customer satisfaction. - Coordinate with other departments to resolve complex claims issues effectively. - Maintain up-to-date knowledge of industry regulations and standards related to claims adjudication. - Utilize technical skills to troubleshoot and resolve any system issues impacting claims processing. - Monitor and report on key performance indicators related to claims adjudication. - Assist in the development and implementation of training programs for new team members. - Contribute to the continuous improvement of claims processes through innovative solutions. - Engage in regular reviews of claims procedures to ensure best practices are followed. - Support the team in achieving departmental goals and objectives. Qualifications - Possess a strong understanding of claims adjudication processes and systems. - Demonstrate experience in handling commercial claims is advantageous. - Exhibit excellent analytical skills to interpret claims data effectively. - Show proficiency in using claims management software and tools. - Display strong communication skills to collaborate with cross-functional teams. - Have a keen eye for detail to ensure accuracy in claims processing. - Be adaptable to work night shifts and manage workload efficiently. Certifications Required Certified Claims Professional (CCP) or equivalent certification in claims management.

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