Claims Quality Review (remote)

Claims Quality Review (remote)

This is a remote position open to any qualified applicant that lives in the United States.

Summary :

Our Cognizant leadership team, working with our client, is currently seeking individuals to perform the following duties and work as part of our established claims adjudication team. We are seeking highly motivated healthcare professionals with auditing experience in professional claims adjudication area. Absences will not be permitted during training-approximately 6 weeks. This is a work-from-home position with day hours, and no travel is required.

This position requires individuals to perform the following duties and work as part of a team

Monitor, evaluate and score transactions against established quality assurance instruments and standards

Participate, as needed, in calibration sessions, communication sessions, and / or creation of communication tools

Supports and communicates business goals, quality standards, processes and procedures and policies

Ensures the claims processing reps adhere to predetermined quality assurance standards and the business's standard operating procedures, serves as Subject Matter Expert

Conduct coaching and feedback sessions as needed

Provides accurate and timely reports on a daily, monthly, month-to-date and year-to-date rolling basis on quality, productivity, availability and other key metrics as determined

Ability to work overtime and / or a flexible schedule based on business, client and / or accounting needs.

Other duties as assigned.

Qualifications :

High school Diploma - REQUIRED

Minimum of one (3) years QA Experience

Minimum of one (5) years Healthcare claims processing experience

Good Spoken & Written English Good Communication Skills

Coaching (Soft) skills

Excel knowledge on charts & tables Knowledge on MS Office applications

High Attention to detail

High Level of Integrity and Ethical Behavior

Salary and Other Compensation : Applications will be accepted until October 13th, 2025.

The hourly rate for this position is between $19.00 - 20.00 per hour, depending on 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 hourly rate, 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.

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.