Provider Appeals & Grievances Specialist (remote)
Cognizant, Phoenix, Arizona, United States, 85003
Overview
Provider Appeals & Grievances Specialist (remote) This is a remote position open to any qualified applicant that lives in the United States. Responsibilities
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
1-2 years of Appeals and Grievance 1 Year of medical claims processing experience (Must be with a healthcare plan, not on behalf of provider or provider’s office) 2 Years of medical health insurance (Must be with a managed healthcare plan, not on behalf of provider or provider’s office) 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 and Other Compensation
The hourly rate for this position is between $19.00 – 20.00 per hour, depending on experience and other qualifications of the successful candidate. This position is 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 Applications will be accepted until February 9, 2026. This position is remote with day hours and no travel required. 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. Cognizant will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future. Cog2026
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Provider Appeals & Grievances Specialist (remote) This is a remote position open to any qualified applicant that lives in the United States. Responsibilities
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
1-2 years of Appeals and Grievance 1 Year of medical claims processing experience (Must be with a healthcare plan, not on behalf of provider or provider’s office) 2 Years of medical health insurance (Must be with a managed healthcare plan, not on behalf of provider or provider’s office) 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 and Other Compensation
The hourly rate for this position is between $19.00 – 20.00 per hour, depending on experience and other qualifications of the successful candidate. This position is 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 Applications will be accepted until February 9, 2026. This position is remote with day hours and no travel required. 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. Cognizant will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future. Cog2026
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