Cognizant Recruitment 2023

Cognizant Hiring Senior Process Executive!

Cognizant Recruitment 2023 :Cognizant has Posted a job opportunity called Senior Process Executive on their website www.cognizant.com Online application. If you’re interested for this Job Opportunity apply fast, you can apply for this Cognizant Recruitment online using the direct link provided in the article. In this article we provide you all the information like educational qualification, age limit, work experience, online registration dates, selection process, application fees, etc.

Cognizant Recruitment 2023 : All Interested and Eligible Applicants can Apply for this Cognizant Job Opportunity. From Instructions Given Below with all Your Important Documents and Certificates. The registration has been started. Applicant should read all information given below on this Page Regarding this Job Opportunity.

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Cognizant Application Link

JOB DESCRIPTION FOR COGNIZANT RECRUITMENT 2023

Post Name : Senior Process Executive

JOB LOCATION : BANGLORE

Educational Qualification :

BE/BTech/MCA

For Medical Management Bachelor’s degree in Nursing or any health science related field.
For NA High School Equiv.

Mode of Application : ONLINE

Job Type : BPO Service Line

Experience : Freshers

Must Have Skills

Retail Pharmacy
Pharmacy

Employee Status : Full Time Employee

Shift : Day Job

Travel : No

Website Name : www.cognizant.com

JOB RESPONSIBILITY

Business / Customer: Data Processes

• Efficiently Process predefined number of transactions as assigned with highest level of accuracy as agreed upon by the client.
• Provide highest level of customer satisfaction.
• Strive to understand and resolve issues/queries at the first instant.
• Maintain the business controls as per the requirement.
• Articulate/ communicate in a manner which is understood by clients / endusers.
• Connect & provide highest level of satisfaction to the customer.

For Member Management:

• Generate clientspecified reports relating to operations.
• Respond to data requests and other inquiries from the client.
• Release WCUM determinations to claim stakeholders following clientestablished protocols.
• Identify the medical flags in the client system.
• Provide reports and other data requests specified by the client.
• Serve as first level contact for customer complaint resolution.
• Provide reports and other data requests specified by the client.

IMPORTANT LINKS FOR COGNIZANT RECRUITMENT 2023

Application Link	Apply Here
Official Website	Click Here
Join Us On Telegram	Join Us

For Claims, RCM, Provider Services and Member Services:

• Make and Answer calls to and from customers/end users based on agreed time frames.
• Transfer calls involving next level of service to the appropriate department as per the given guidelines.

Project / Process: Data Processes:

• Ensure to meet all Statistical, Financial and TAT metrics while processing claims.
• 100% Process adherence to transaction processing timelines involving medical management processes.
• Adhere to audit compliance (Internal, Statutory Audit) of all Healthcare processes as laid out by Cognizant / the client of Cognizant.
• Ensure process guidelines are followed and met as documented.
• Set productivity /Quality benchmark.
• Adhere to shift handover processes.
• Raise process related issues / concerns on time with process and team leads.
• Record data relating to production statistics, enduser related notes, etc as appropriate.
• Stay updated with the process knowledge / changes refer to knowledge updates/ repositories to effectively process transactions.
• Adhere to security practices set by organization.
• Implement small process improvement projects.
• Provide updates and submit reports related to own area of work.
• Resolve process related queries and expedite on data requests.
• Respond to data requests.
• Maintain confidentiality of all information, policies, and procedures as required by the Health Insurance Portability and Accountability Act (HIPAA) protocols.
• Maintain acceptable levels of performance including but not limited to attendance, adherence to protocols, customer courtesy, and all other productivity and efficiency targets and objectives.
• Contribute new ideas and innovative approaches at work.
• Participate in project and organization initiatives led by the Delivery leadership.

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DOT RECRUITMENT 2023|डिपार्टमेंट ऑफ टेलीकम्युनिकेशन मुंबई येथे विविध पदांसाठी भरती!!!

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INFOSYS PUNE RECRUITMENT 2023|इन्फोसिस मध्ये प्रोसेस EXECUTIVE जॉब्स

For Medical Management:

• Identify cases eligible for medical reviews and assign these to appropriate reviewers.
• Reach out to the client for any problems identified in the cases for review.
• Adhere to Utilization Review Accreditation Commission (URAC), jurisdictional, and/or established MediCall best practice UM time frames, as appropriate.
• Adhere to federal, state, URAC, client, and established MediCall best practice WCUM time frames, as appropriate.
• Develop a complete understanding of the Medical management Procedures.
• Perform medical review assessment (MRA) on utilization of health services (eg healthcare plans, workers compensation products etc) in an accurate, efficient and timely manner while ensuring compliance with utilization management regulations and adherence to state and federal mandates.
• Provide succinct negotiable points based on the submitted medical records that identify necessary medical treatment, casually related care, response or lack of response to treatment, etc.
• Identify missing records and information that are necessary in the completion of the medical review assessment.
• Adhere to Department of Labor, state and company timeframe requirements.
• Coordinates physician reviewer referral as needed and follows up timely to obtain and deliver those results.
• Track status of all utilization management reviews in progress and follow up on all pending cases.
• Work closely with management team in the ongoing development and implementation of utilization management programs.
• Respond to inbound telephone calls pertaining to medical reviews in a timely manner, following clientestablished protocols.
• Learn new methods and services as the job requires.
• Advise supervisor of any potential problems as they become evident.
• Manage assigned workload within established performance standards.
• Perform quality control on medical review assessments generated by the medical review process.
• Utilize the approved monitoring tool and updated template completion guidelines as required to compile and track performance of each associate.
• Provide feedback to the Team Leads and Manager on the performance of each associate and the team as a whole.
• Maintain and secure confidentiality of Client’s data and all individually identifiable health information accessed through the client’s and/or Cognizant’s systems.
• Coordinates with the immediate superior regarding updates in policies, procedures and process flow, and state requirements.
• Learn new protocols and systems as the job requires.
• Escalate to the immediate superior any unforeseen events or situation beyond assigned tasks and jurisdiction.

For Claims:

• Process Claims documents with zero critical errors and complete claims transaction volumes in queue within the specified TAT.
• Contribute towards creation of knowledge updates & stay updated with process knowledge / changes.
• Advice and counsel employees on benefit related issues in accordance with the Certified and classified Master Agreements and Administrative Program enabling proper and complete utilization of existing and new benefits.
• Code complex plans in the system after thoroughly analyzing the source documents.
• Benefit Plan analysis where she/he creates the source document for coders by reviewing the master agreement document.

RCM:

• Follow up on all pending claims appropriately and initiate the next steps.
• Complete transactions for claims submissions, rejections, Payment posting as defined in SOP’s.
• Complete coding transactions with the required ICD, CPT and other requirements.
• Highlight global issues in the respective hospital accounts.
• Cross training on multiple process.

Cognizant Application Link