Cognizant is a large IT Consulting Firm that leverages modern technologies to transform a variety of business operations. We are seeking Fully Remote US Based Claims Processors to join our growing team. Claim processors will review claim submissions, verify information, adjudicate or adjust the claim as per claim processing guidelines to ensure appropriate payment or denial as per the business requirements.
Role Responsibilities
Quality Audit
- Ensures agent compliance and adherence to client procedures / policy by reviewing agent activity within the defined quality systems
Root Cause Analysis
Conducts weekly RCA of errors and assists in creating a weekly deck for review with operations, training, and quality team
Assess agent performance through audit monitoring as well as 1-2-1 investigatory sessions to identify error trends and performance opportunities
Works closely with Quality Team Lead and Manager to aggregate, prioritize, and report on the top issues impacting the program
Contributes error analysis and insights for the preparation of the Weekly Quality reports and decks
Process Improvements
Develop and maintain inventory of improvement ideas focused on error reduction and improvement of process health and performance
Quality Monitoring and Coaching
Provides analysis and recommendations for process improvement, productivity, accuracy & turnaround time
Calibration / Global Alignment
Attend quality calibrations and syncs to maintain alignment on process/policy understanding and application
Perform calibration audits in sync with program SMEs and TLs to ensure audit accuracy and alignment
Communication:
Update trackers and required applications & tools and keep management informed of emerging issues/risks
Creation of daily, weekly, monthly reports monitoring associate and program performance to be shared with leadership
Coaching & Feedback
Program Governance
Works alongside the training team to provide insights into error trends, process gaps and performance adherence to develop assessments and knowledge checks for reviewer workflow certifications
Monitor and adhere to policy and process change guidelines and expectations. Including providing feedback and clarification on identified changes.
Conducts quarterly reviews of SOPs to ensure they are aligned to the current processes and policy
Develop and maintain process documentation which outlines the quality program and approach
Personal Excellence
Meet/Exceed targets set within the key activities
Be an exceptional team player when it comes to knowledge sharing, training, people development and reporting
Participate in special projects/manage individual projects, and act as a guide to ensure the project meets SLA's
Strives to identify new opportunities to provide a better reviewer and end-user experience
Evaluates processes and make recommendations for improvement
Contribute to and participate proactively in knowledge sharing sessions
Participate and contribute to organizational activities
Desired Skills & Experience
At least a High School Diploma or equivalent is required
Proven expertise in all workflows
Minimum 18 months' experience in full-time Operations role
Exceptional English communication skills
Working Environment Requirement
Ability to work remotely in a secure environment (Required)
Must have high-speed internet connection ( Required)
Must have highs-speed internet modem with ability to connect laptop to wired connection port (Required)
Must have a workspace and location free from distractions and safety of healthcare data (Required)
Salary and Other Compensation
Applications will be accepted until May 22nd, 2026.
The hourly rate for this position is between $15 - $117 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 will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.
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.
