Job Description

This is a remote position open to any qualified applicant in the United States. Overview: We are actively seeking a Team Manager that will help develop, evaluate, and manage claim adjustments,  projects, and Maestro Customer Service portal requests. Responsibilities: - Assess individual and team performance on a regular basis and provide developmental feedback - Identify and escalate opportunities for efficiencies intended to reduce rework - Evaluate business processes and perform high level analysis to leverage opportunities for operational improvements - Perform initial root-cause analysis of workflow and break-fixes - Overall goal is to process claims accurately and efficiently while reducing administrative costs - Manage and supervise daily workflow and preparation of daily, weekly, monthly production and inventory reports to ensure business objectives are maintained within State and Federal compliance mandates, including but not limited to: HIPAA, SOX, ERISA, Prompt Pay and Regulatory requirements - Serve as Subject Matter Expert, clarify benefits, review procedural documents and system/benefit/contract configurations to determine validity of inquiry - Resolution of day-to-day front-line issues and questionable Claims/Shared Services outcomes reported by staff, Government Programs, Grievance and Appeals, Provider Relations, Providers, Service, etc. - Contribute to the development of business and technical requirements for system improvements - Identify and coordinate training and tools to ensure staff members are operating at desired skill levels. Required Qualifications: - 2+ years managerial/supervisory experience within a related healthcare and/or claims environment - 5+ years in claims processing - Strong knowledge of claims processing, procedures and systems, State, Federal and Medicare Regulations and Coordination of Benefits applications - High School Diploma or Equivalent Preferred Qualifications: - Bachelors Degree - Facets experience Cognizant will only consider applicants for this position whom are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.