Claims Processor

4 weeks ago

Nashville, United States Remote Staffing Full time

Claims Processor (Remote)This position is open to any qualified candidate living in the United States. Key responsibilities include:Claims Processing: Review, validate, and process healthcare claims submitted by providers in accordance with US insurance policies.Eligibility Verification: Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid, and private insurance plans.Adjudication: Approve, deny, or adjust claims based on payer guidelines and policy terms.Compliance: Maintain adherence to HIPAA regulations, CMS guidelines, and other US healthcare compliance standards.Documentation: Record claim activity, maintain audit trails, and prepare reports for management.Required skills and qualifications:High school diploma or equivalent required.Strong knowledge of US healthcare insurance systems (Medicare, Medicaid, commercial payers).24 years of experience in US healthcare claims processing.Familiarity with claims management software and EDI transactions.Excellent analytical, organizational, and communication skills.Ability to interpret insurance policies and payer guidelines.Detail-oriented with strong problem-solving abilities.Competencies: Regulatory Knowledge Deep understanding of US healthcare laws and payer requirements. Accuracy & Detail Orientation Ensures claims are processed correctly and efficiently. Problem-Solving Resolves claim disputes and denials effectively.Salary and other compensation: Applications will be accepted until November 18, 2025. 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 InsurancePaid holidays plus Paid Time Off401(k) plan and contributionsLong-term/Short-term DisabilityPaid Parental LeaveEmployee Stock Purchase PlanDisclaimer: 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 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.

  • Senior Claims Processor- Remote

    1 week ago

    Nashville, TN, United States Chubb Full time

    Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured depending on the line of business. to secure necessary claim information. Evaluates facts supplied by investigation to determine extent of liability of...

  • Claims Examiner

    3 hours ago

    Nashville, United States HCA Full time

    Description * This role prefers candidates local to California and/or Pacific Time Zone* Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Claims Examiner today with Work from Home. Benefits Work from Home offers a total...

  • Claims Operations Lead

    8 hours ago

    Nashville, United States HCA Full time

    Description * This role prefers candidates local to California and/or Pacific Time Zone* Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Claims Operations Lead today with Work from Home. Benefits Work from Home offers a...

  • Death Claims Analyst

    7 days ago

    Nashville, United States DXC Technology Full time

    A global technology firm is seeking a Death Claims Processor in Nashville, TN. The role requires strong customer service skills and a minimum of 2 years experience in life insurance claims processing. Responsibilities include handling transactions, maintaining accurate records, and improving processes for better customer experiences. This full-time position...

  • CPC Processor Customer Support Remote

    2 weeks ago

    Nashville, United States Nashville Staffing Full time

    Cpc Processor I Customer SupportDatavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and...

  • Prep Cook

    2 weeks ago

    Nashville, United States Chilli's Full time

    Prep Cook - Vanderbilt Chili's2322 W. End Ave.Nashville, TN 37203< Back to search resultsRole OverviewOur Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you!Fast hiring...

  • Line Cook

    2 weeks ago

    Nashville, United States Chilli's Full time

    Line Cook - Vanderbilt Chili's2322 W. End Ave.Nashville, TN 37203< Back to search resultsRole OverviewOur Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you!Fast hiring...

  • Line Cook

    2 weeks ago

    Nashville, United States Chilli's Full time

    Line Cook - Opry Mills Chili's451 Opry Mills DriveNashville, TN 37214< Back to search resultsRole OverviewOur Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you!Fast hiring...

  • Line Cook

    2 weeks ago

    Nashville, United States Chilli's Full time

    Line Cook - Bellevue Chili's7624 Highway 70 SNashville, TN 37221< Back to search resultsRole OverviewOur Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you!Fast hiring...

  • Line Cook

    2 weeks ago

    Nashville, United States Chilli's Full time

    Line Cook - Bellevue Chili's 7624 Highway 70 S Nashville, TN 37221 < Back to search results Role Overview Our Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you! * Fast hiring...