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SPE-Claims HC

Cognizant

2 - 5 years

Bengaluru

Posted: 27/08/2025

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Job Description



Job Summary

Clinical claim Review


Responsibilities

  • Oversee the claims adjudication process to ensure accuracy and compliance with industry standards.
  • Provide expertise in claims and payer domains to enhance operational efficiency.
  • Analyze claims data to identify trends and areas for improvement.
  • Collaborate with team members to streamline claims processing workflows.
  • Ensure timely resolution of claims issues to maintain customer satisfaction.
  • Develop and implement strategies to optimize claims adjudication procedures.
  • Monitor performance metrics to ensure adherence to service level agreements.
  • Communicate effectively with stakeholders to address claims-related inquiries.
  • Utilize technical skills to troubleshoot and resolve claims processing challenges.
  • Maintain up-to-date knowledge of industry regulations and best practices.
  • Contribute to the development of training materials for claims processing staff.
  • Support continuous improvement initiatives to enhance claims operations.
  • Document and report on claims processing activities for management review.

    • Qualifications

  • Possess strong analytical skills to evaluate claims data and identify improvement opportunities.
  • Demonstrate proficiency in claims adjudication processes and techniques.
  • Exhibit excellent communication skills to interact with stakeholders effectively.
  • Show a keen understanding of payer domain requirements and regulations.
  • Have the ability to work independently in a remote work environment.
  • Display strong problem-solving skills to address claims processing challenges.
  • Maintain a detail-oriented approach to ensure accuracy in claims adjudication.

    • Certifications Required

    BSC Nursing with minimum 2 + years of Clinical experience

    About Company

    Cognizant is a global leader in technology and consulting services, helping businesses transform their operations through digital solutions. Specializing in IT services, including software development, business process outsourcing, and consulting, Cognizant supports clients across industries such as healthcare, financial services, manufacturing, and retail. With a focus on innovation, Cognizant assists organizations in modernizing their technology, improving operational efficiency, and enhancing customer experiences. Headquartered in the U.S., it is consistently ranked among the most admired companies in the world and is a member of the NASDAQ-100.

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