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Spe-Claims Hc

Cognizant
Cognizant
2-3 years
Not Disclosed
10 Jan. 8, 2026
Job Description
Job Type: Full Time Education: B.Sc/M.Sc/M.Pharma/B.Pharma/Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Claims Specialist – Healthcare (SPE)

Job ID: 00066846961
Location: Bangalore, India
Job Category: Technology & Engineering | Healthcare Operations
Work Model: Work from Home | Day Shifts
Experience Required: 2–3 years


Job Overview

Cognizant is seeking a Claims Specialist – Healthcare (SPE) to join our dynamic team in Bangalore. This work-from-home role focuses on healthcare claims adjudication, emphasizing payer domain expertise. The ideal candidate will ensure accurate and timely processing of healthcare claims while optimizing operational efficiency and enhancing customer satisfaction.

This position offers flexibility, work-life balance, and exposure to global healthcare operations.


Key Responsibilities

  • Analyze and process healthcare claims in accordance with adjudication guidelines, policies, and payer requirements.

  • Resolve complex claim issues by collaborating with cross-functional teams and internal stakeholders.

  • Identify discrepancies and implement corrective actions to improve claim processing accuracy.

  • Monitor claim metrics and provide actionable insights for process improvement.

  • Ensure timely adjudication of claims to meet service level agreements (SLAs).

  • Develop, maintain, and update documentation of claims adjudication processes and procedures.

  • Participate in training and knowledge-sharing sessions to stay current with industry standards and best practices.

  • Support the implementation of new technologies and tools to enhance claims processing efficiency.

  • Conduct audits to ensure regulatory compliance and adherence to healthcare standards.

  • Provide feedback to management on process optimizations for better operational outcomes.

  • Assist in generating reports and presentations to communicate claims outcomes and insights.


Required Qualifications

  • BSc Nursing with 2–3 years of clinical experience.

  • Strong proficiency in claims adjudication processes and techniques.

  • Excellent analytical skills to identify and resolve claim discrepancies.

  • Attention to detail to maintain accuracy and compliance.

  • Effective communication skills for engaging with healthcare teams and stakeholders.

  • Familiarity with payer domain operations, healthcare regulations, and industry standards.

  • Ability to work efficiently in a dynamic, fast-paced environment.


Why Join Cognizant

Cognizant is a global leader in professional services, transforming business, technology, and operations for the digital era. Employees become part of a high-performing, inclusive, and collaborative workforce that drives innovation and operational excellence.

  • Global community of 300,000+ associates

  • Flexible remote and hybrid work options

  • Opportunities for professional development and career growth

  • Exposure to global healthcare operations and innovative solutions

  • Recognized as Forbes World’s Best Employers 2025


Equal Opportunity Statement

Cognizant is an equal opportunity employer. Employment decisions are based on merit, experience, and business needs. All qualified applicants will receive consideration without regard to race, color, sex, religion, sexual orientation, gender identity, national origin, disability, veteran status, or any other legally protected characteristic.