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Enrollment Examiner
4 months ago
**Join Our Team at Cognizant: Pioneering Solutions, Transforming Futures**:
At Cognizant, we're not just about technology; we're about pioneering solutions that create meaningful transformations. We're looking for innovative minds, problem-solvers who are passionate about making a difference in the fast-paced world of technology. If you're ready to challenge the status quo and drive excellence, we want you on our team.
**Purpose**:
Enrollment examiners will review enrollment records, identify discrepancies, and reconcile member records per the enrollment guidelines to ensure data integrity is sound for all member records.
**Essential functions**:
1. Reviewing member records from an enrollment perspective, reviewing eligibility dates, plans, primary care provider information, and other pertinent information related to the enrollment of a member.
2. Comparing and reconciling all enrollment information to the 834 file and reconciling the record, making changes in the system to ensure the correct information is present for each member.
3. Enrolling new or reinstated members into the system per request.
4. Reviewing and reconciling Third Party Liability records for member records.
5. Follows all team procedures, including HIPAA policies and procedures, and meets team quality, turnaround time and productivity performance standards and goals.
6. Maintaining internal customer relations by interacting with staff regarding enrollment issues and research, ensuring accurate and complete enrollment record information, contacting insured or other involved parties for additional or missing information.
7. Other duties as assigned
**Qualifications**:
**Education**:High School diploma or GED required.
**Experience**:
- Minium one year of Medicaid, Medicare and/or Commercial enrollment processing experience
- Facets and/or EAM experience preferred
**Technical Competencies**:
8. Ability to work remotely and independently
9. Strong attention to detail
10. Strong interpersonal, time management and organizational skills
11. Good oral/written communication and analytical skills
12. Must be able to work in a high performance environment that changes often
13. Experience in navigating multiple systems using dual monitors
14. Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes, and standard of billing guidelines required.
15. FACETS experience preferred
16. Medicaid or Medicare knowledge preferred
17. Keyboard skills of at least 35 WPM + 10-key
18. Proficient in Microsoft Office - Excel, Word, and Outlook
**Location: Fully Remote**:
**Salary and Other Compensation**:
- 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
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.
**The Cognizant community**:
We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive.
- Cognizant is a global community with more than 345,000 associates around the world.
- We don’t just dream of a better way - we make it happen.
- We take care of our people, clients, company, communities and climate by doing what’s right.
- We foster an innovative environment where you can build the career path that’s right for you.
**About us**:
Cognizant (Nasdaq-100: CTSH) is one of the world's leading professional services companies, helping organizations modernize technology, reimagine processes and transform experiences so they stay ahead in a fast-changing world.
**Our commitment to diversity and inclusion**:
**Disclaimer**:
