Cognizant
Provider Appeals & Grievances Specialist (remote)
Cognizant, Phoenix, Arizona, United States, 85003
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Provider Appeals & Grievances Specialist (remote)
role at
Cognizant .
This is a remote position open to any qualified applicant that lives in the United States.
Summary We are seeking a dedicated Provider Appeals & Grievance Specialist with 1 to 2 years of experience to join our team. The ideal candidate will have strong technical skills in MS Excel, knowledge/navigation skills for Microsoft programs, and dedication to attendance adherence. Absences will not be permitted during training—approximately 6 weeks. This is a work-from-home position with hours from Monday to Friday from 8 am – 4:30 pm EST, and no travel is required.
Candidate will also have the desire to further their abilities and knowledge of Medicaid medical insurance processes as they will be responsible for the research and resolution of Medicaid provider appeals that will involve research of member benefits, eligibility, provider contracts, billing and coding, utilization management, and state Medicaid policies.
Qualifications & Skills
2 years minimum Appeals and Grievance experience
2 years medical claims processing experience (Must be with a healthcare plan, not on behalf of provider or provider’s office)
Medicaid insurance customer service or claims processing
Medicaid/Medicare Insurance Customer Service with managed care plans or directly with CMS
Billing and Coding - Medical Insurance
Knowledge of Member/Provider Appeals and Grievances, processes, resolutions, compliance TAT
Self-resolved troubleshooting ability for various IT issues
Knowledge of QNXT
Knowledge of PEGA
Knowledge of SharePoint
Sense of urgency with production and responsiveness to email and MS Teams
Ability to create and fax written communication in a professional manner including spelling and grammar
Salary & Compensation Applications will be accepted until November 5, 2025. The hourly rate for this position is between $17.00 – $18.00 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
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
Disclaimer:
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.
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Provider Appeals & Grievances Specialist (remote)
role at
Cognizant .
This is a remote position open to any qualified applicant that lives in the United States.
Summary We are seeking a dedicated Provider Appeals & Grievance Specialist with 1 to 2 years of experience to join our team. The ideal candidate will have strong technical skills in MS Excel, knowledge/navigation skills for Microsoft programs, and dedication to attendance adherence. Absences will not be permitted during training—approximately 6 weeks. This is a work-from-home position with hours from Monday to Friday from 8 am – 4:30 pm EST, and no travel is required.
Candidate will also have the desire to further their abilities and knowledge of Medicaid medical insurance processes as they will be responsible for the research and resolution of Medicaid provider appeals that will involve research of member benefits, eligibility, provider contracts, billing and coding, utilization management, and state Medicaid policies.
Qualifications & Skills
2 years minimum Appeals and Grievance experience
2 years medical claims processing experience (Must be with a healthcare plan, not on behalf of provider or provider’s office)
Medicaid insurance customer service or claims processing
Medicaid/Medicare Insurance Customer Service with managed care plans or directly with CMS
Billing and Coding - Medical Insurance
Knowledge of Member/Provider Appeals and Grievances, processes, resolutions, compliance TAT
Self-resolved troubleshooting ability for various IT issues
Knowledge of QNXT
Knowledge of PEGA
Knowledge of SharePoint
Sense of urgency with production and responsiveness to email and MS Teams
Ability to create and fax written communication in a professional manner including spelling and grammar
Salary & Compensation Applications will be accepted until November 5, 2025. The hourly rate for this position is between $17.00 – $18.00 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
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
Disclaimer:
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.
#J-18808-Ljbffr