SPE-Claims HC

3 days ago

Coimbatore, Tamil Nadu, India Cognizant Technology Solutions Full time ₹ 9,00,000 - ₹ 12,00,000 per year

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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