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Claims Analyst

Phoenix, AZ
Role: Claims Processors
Location: Phoenix, AZ
Duration: 6+ Months
Interview Mode: Face to Face
Client: Cognizant
Hourly rate $16.00
Hourly rate $18.00(Must have FACETS exp)


Job Description
 
PROCESS: Claims Adjudication/Adjustments
ROLE: Each associate will be responsible for adjudicating/adjusting claims submitted by members and providers.  The process will include reviewing claims based on preset criteria given by client, pending, approving or denying the claim on a case-by-case basis. A set of these claims will go to the prepay auditor who is expected to review the claim and audit for procedural and financial accuracy.
REPORTING TO: Team Leader/Team Manager
ESSENTIAL QUALIFICATION:
Overview of US Healthcare Industry
A-Level professional with 1-2 years of experience in claims processing
Good logical thinking & analytical ability
Should have exposure to MS Office (high proficiency with MS Excel)
Good keyboard skills, typing speed of 30 wpm or more
Good verbal & written communication skills, ability to interact via email/online applications
 
ESSENTIAL SKILLS/PERSONALITY TRAITS:
 
Eye for detail
Logical thinking & analytical skills
Ability to work with limited supervision
Ability to work accurately and efficiently at all times, including redundant claim types
Ability to multi-task and manage time efficiently under the pressure of deadlines
Sensitivity to the confidential nature of the data and proprietary company information
 
OPERATIONAL RESPONSIBILITY:
Ensure to meet all Statistical, Financial and TAT metrics while processing claims
100% adherence to transaction processing timelines
Adhere to audit compliance (Internal, Statutory Audit) of all Healthcare processes as laid out by Cognizant / the client of Cognizant
Ensure process guidelines are followed and met as documented
 
PERFORMANCE STANDARDS:
MEASURABLE
Number of claims adjudicated/adjusted in a day
Accurate and thorough review of all assigned claims
Turnaround Time
Attendance and Punctuality
 
NON-MEASURABLE:
Self-motivation
Team Player
Reliability
Professionalism
Personal grooming and etiquette
 
 
 
 
Regards,

Rahul Yadav
(408) 560-3956
rahul@reqroute.com
Companies across U.S. have engaged ReqRoute, Inc to deliver skilled, dedicated IT professionals. Recruiting is our passion and we support Fortune 1000 companies with their hiring needs. We always seek to deliver competitive and sought-after career opportunities to our potential consultants and employees. We invite you to review the position requirements and apply today if your skills match our needs.  
 
ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. (www.reqroute.com)

 
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