Claims Processor (remote)

Job Description

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

• Review, validate, and process healthcare claims in accordance with client policies, procedures, benefit guidelines, and regulatory requirements.
• Verify member, provider, authorization, eligibility, benefits, diagnosis, procedure, and claim information prior to claims adjudication or resolution.
• Research claim edits, denials, suspensions, duplicates, coordination of benefits issues, and other exceptions using applicable systems and knowledge resources.
• Accurately document claim actions, notes, outcomes, and supporting details in the appropriate claims processing platforms.
• Meet established productivity, quality, accuracy, attendance, and turnaround time expectations while maintaining confidentiality and compliance standards.
• Identify trends, errors, or process gaps and escalate issues to the appropriate team lead, supervisor, or support group as needed.
• Support claim rework, adjustment, reconsideration, and correction activities as assigned by the business or client.
• Collaborate with internal teams including quality, training, operations, provider/member support, and subject matter experts to resolve claims-related issues.
• Maintain working knowledge of standard operating procedures, client updates, job aids, and healthcare claims processing guidelines.
• Assist with special projects, inventory clean-up, peak season support, and additional operational tasks as required.

Qualifications

The ideal candidate will possess the following skills and experience:

• College graduate preferred or at least completed two (2) years of college education with no back subjects.
• Minimum of one (1) year of healthcare, claims processing, back-office operations, contact center, or administrative experience preferred.
• Knowledge of healthcare claims, benefits, eligibility, provider/member information, or insurance terminology is preferred.
• Good spoken and written English communication skills.
• Strong data entry, analytical, research, and problem-solving skills.
• Working knowledge of Microsoft Office applications, especially Excel, Outlook, and Teams.
• High attention to detail with ability to follow job aids, standard operating procedures, and client-specific instructions.
• Ability to manage workload, prioritize claim inventory, and meet daily productivity and quality goals.
• High level of integrity, ethical behavior, confidentiality, and compliance mindset, including handling protected health information appropriately.

Physical Demands

While performing the responsibilities of the job, the employee is required to talk and hear. The employee is often required to sit and use their hands and fingers to handle or feel. The employee is occasionally required to stand, walk, reach with arms and hands, and to stoop, kneel, or crawl. Vision abilities required to perform this job include close vision. Work Environment While performing the duties of this job, the employee is typically working in an office, call center, or remote work environment. The noise level in the work environment is usually quiet to moderate. The passage of employees through the work area is average and normal.

Salary And Other Compensation

Applications will be accepted until August 30, 2026. The hourly rate for this position is between $16.00 – 17.00 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. Cog2026