Pe-claims Hc

4 days ago

Chennai Tamil Nadu, India Cognizant Full time

**Job Summary**

Join our dynamic team as a PE-Claims HC specialist where you will play a crucial role in processing and adjudicating claims with precision and efficiency. This hybrid role requires a keen understanding of Medicare and Medicaid claims ensuring compliance and accuracy. With a focus on night shifts you will contribute to our mission of delivering exceptional healthcare solutions without the need for travel.

**Responsibilities**
- Process claims with a high degree of accuracy ensuring compliance with Medicare and Medicaid regulations.
- Analyze claims data to identify discrepancies and resolve issues promptly.
- Collaborate with team members to streamline claims adjudication processes.
- Maintain up-to-date knowledge of industry standards and regulatory changes.
- Utilize technical skills to enhance claims processing efficiency.
- Communicate effectively with stakeholders to ensure clarity and understanding of claims processes.
- Implement best practices to improve overall claims management.
- Monitor claims processing metrics to ensure timely and accurate adjudication.
- Provide feedback and suggestions for process improvements.
- Support the team in achieving departmental goals and objectives.
- Ensure all claims are processed within established timelines.
- Assist in the development of training materials for new team members.
- Contribute to a positive work environment by fostering collaboration and teamwork.

**Qualifications**
- Possess strong analytical skills to assess and adjudicate claims accurately.
- Demonstrate proficiency in claims adjudication processes and tools.
- Exhibit a solid understanding of Medicare and Medicaid claims requirements.
- Show excellent communication skills to interact with various stakeholders.
- Have the ability to work effectively in a hybrid work model.
- Display a keen attention to detail to ensure compliance and accuracy.

**Certifications Required**

N / A

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