Your browser does not support javascript! Please enable it, otherwise web will not work for you.

SME-Claims HC @ Cognizant

Home > Operations

 SME-Claims HC

Job Description



Job Summary

Join our team as a Subject Matter Expert in Claims HC where you will leverage your expertise in Facets Claims and Claims Adjudication to optimize our claims processing systems. With a focus on Dental and Commercial Claims you will play a pivotal role in enhancing operational efficiency and ensuring compliance with industry standards. This office-based role offers the opportunity to work in a dynamic environment contributing to impactful projects that benefit both the company and society.


Responsibilities

  • Lead the analysis and optimization of claims processing workflows to enhance efficiency and accuracy.
  • Oversee the implementation of Facets Claims and Claims Adjudication systems to ensure seamless integration and functionality.
  • Provide expert guidance on Dental and Commercial Claims processes to ensure compliance with industry standards.
  • Collaborate with cross-functional teams to identify and resolve system issues improving overall operational performance.
  • Develop and maintain documentation for claims processing procedures to support training and knowledge sharing.
  • Monitor and evaluate system performance recommending improvements to enhance service delivery.
  • Conduct regular audits of claims processes to ensure adherence to regulatory requirements and company policies.
  • Facilitate training sessions for team members to enhance their understanding of claims systems and processes.
  • Analyze data trends to identify opportunities for process improvements and cost savings.
  • Support the development of new claims processing initiatives to drive innovation and efficiency.
  • Communicate effectively with stakeholders to provide updates on project progress and system enhancements.
  • Ensure that all claims processing activities align with the companys strategic goals and objectives.
  • Contribute to the development of best practices for claims management to support continuous improvement. Qualifications
  • Demonstrate proficiency in Facets Claims and Claims Adjudication with a strong understanding of system functionalities.
  • Possess in-depth knowledge of Dental and Commercial Claims processes and industry standards.
  • Exhibit excellent analytical skills to identify and resolve complex system issues.
  • Show strong communication skills in English both written and verbal to effectively collaborate with team members.
  • Display a proactive approach to problem-solving and process improvement.
  • Have a minimum of 5 years of experience in claims processing with a focus on Dental and Commercial Claims.
  • Be able to work independently and manage multiple tasks in a fast-paced environment.

    • Certifications Required

    Certified Professional Coder (CPC) or equivalent certification in claims processing.

    Job Classification

    Industry: IT Services & Consulting
    Functional Area / Department: Customer Success, Service & Operations
    Role Category: Operations
    Role: Subject Matter Expert
    Employement Type: Full time

    Contact Details:

    Company: Cognizant
    Location(s): Bengaluru

    + View Contact

    Keyskills:   process commercial analytical workflow us healthcare verbal communication claims adjudication process improvement monitoring claims processing system continuous improvement service delivery compliance writing claims english processing communication skills

     Job seems aged, it may have been expired!
     Fraud Alert to job seekers!

    ₹ Not Disclosed

    Similar positions

    Quality Team Lead - AR (Hospital billing) - US healthcare!!

    • Omega Healthcare
    • 7 - 11 years
    • Chennai
    • 2 mths ago
    ₹ Not Disclosed

    Manager operations (Surgery Coding) from US Healthcare Co.

    • Leading RCM company
    • 10 - 20 years
    • Noida, Gurugram
    • 2 mths ago
    ₹ 20-32.5 Lacs P.A.

    Quality Team Lead - AR (Hospital billing) - US healthcare!!

    • Omega Healthcare
    • 7 - 11 years
    • Chennai
    • 2 mths ago
    ₹ Not Disclosed

    Quality Team Lead - AR (Hospital billing) - US healthcare!!

    • Omega Healthcare
    • 7 - 11 years
    • Chennai
    • 2 mths ago
    ₹ Not Disclosed

    Cognizant

    Seven Consultancy is a result of the motivation of young entrepreneurship under the guidance of experienced professional from industry. Young entrepreneurs know the recent trends of market. Flexibility of the services has helped Seven consultancy to secure a brand name in the market. So we have acce...

    IndigoJobs.in © 2025

    For enquiries: contact(at)indigojobs.in

    We are in open beta version of website, please let us know if any issues, at: info(at)indigojobs.in