Claims Examiner (remote)

Join to apply for the Claims Examiner (remote) role at CognizantJoin to apply for the Claims Examiner (remote) role at CognizantGet AI-powered advice on this job and more exclusive features.Claims Examiner (remote)This is a remote position open to any qualified applicant in the United States.PurposeClaim processors will review claim submissions, verify information, adjudicate the claim as per claim processing guidelines to ensure appropriate payment or denial as per the business requirements.Essential FunctionsExamining and entering basic claims for appropriateness of care and completeness of information in accordance with accepted coverage guidelines, ensuring all mandated government and state regulations are regularly met.Processing claims for multiple plans with automated and manual differences in benefits, as well as utilizing the system and written documentation to determine the appropriate payment for a specific benefitApproving, pending, or denying payment according to the accepted coverage guidelinesFollows all team procedures, including HIPAA policies and procedures, and meets team quality, turnaround time and productivity performance standards and goalsIdentifying and referring all claims with potential third-party liability (i.e., subrogation, COB, MVA, stop loss claims, and potential stop loss files)Maintaining internal customer relations by interacting with staff regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing information, and updating information to claim file with regard to claims status, questions or claim paymentsOther duties as assignedMust be willing to work overtime when the business need requires.QualificationsEducation: High School diploma or GED required.Experience: Minium of two to three years of Medicaid and or Commerical claims payer processing experience.Technical CompetenciesAbility to work independentlyStrong attention to detailStrong interpersonal, time management and organizational skillsGood oral/written communication and analytical skillsMust be able to work in a high-performance environment that changes oftenExperience in navigating multiple systems using dual monitorsKnowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes, and standard of billing guidelines required.FACETS experience (Highly Preferred)Medicaid knowledge (Required)Keyboard skills of at least 35 WPM + 10-keyProficient in Microsoft Office - Excel, Word, and OutlookHealthcare claims payer processing experience (Required)Ability to work in a high pace while maintaining quality and productivity targetsWorking EnvironmentAbility to work remotely in a secure environment (Required)Must have high-speed internet connection (Required)Must have highs-speed internet modem with ability to connect laptop to wired connection port (Required)Must have a workspace and location free from distractions and safety of healthcare data (Required)Salary And Other CompensationApplications will be accepted until May 31, 2025.The hourly rate for this position is between $18.00 - 19.00 per hour, depending on experience and otherQualifications Of The Successful Candidate.This position is also eligible for Cognizant's discretionary annual incentive program, based on performance andsubject 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 thisposting. Cognizant reserves the right to modify this information at any time, subject to applicable law.Seniority levelSeniority levelEntry levelEmployment typeEmployment typeFull-timeJob functionJob functionFinance and SalesIndustriesIT Services and IT Consulting and Business Consulting and ServicesReferrals increase your chances of interviewing at Cognizant by 2xSign in to set job alerts for "Claims Examiner" roles.Associate Disability Claims Examiner (STD, Remote)Phoenix, AZ $67,900.00-$127,600.00 1 day agoPhoenix, AZ $61,000.00-$68,000.00 4 weeks agoPharmacy Customer Service Representative - National RemotePhoenix, AZ $61,000.00-$64,000.00 2 weeks agoENTRY LEVEL - Customer Service Rep - WORK FROM HOME!!ENTRY LEVEL - Customer Service Rep - WORK FROM HOME!!ENTRY LEVEL - Customer Service Rep - WORK FROM HOME!!Phoenix, AZ $50,920.00-$63,660.00 13 hours agoENTRY LEVEL - Customer Service Rep - WORK FROM HOME!!Paradise Valley, AZ $63,590.00-$114,450.00 1 day agoPhoenix, AZ $51,000.00-$66,000.00 2 weeks agoScottsdale, AZ $54,550.00-$97,750.00 1 day agoENTRY LEVEL - Customer Service Rep - WORK FROM HOME!!Customer Service Representative - Remote in MST or PSTENTRY LEVEL - Customer Service Rep - WORK FROM HOME!!ENTRY LEVEL - Customer Service Rep - WORK FROM HOME!!Scottsdale, AZ $63,590.00-$114,450.00 1 day agoENTRY LEVEL - Customer Service Rep - WORK FROM HOME!!Phoenix, AZ $63,590.00-$114,450.00 1 day agoParadise Valley, AZ $43,680.00-$76,610.00 1 day agoTempe, AZ $63,590.00-$114,450.00 1 day agoEntry Level Customer Service Rep - Work From Home - In AZ ONLYAppointment Customer Representative | Work From HomeWe're unlocking community knowledge in a new way. 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Created: 2026-04-20