Walk-in || Claims Associate

Dear Candidate,

We are hiring for SPE / SME Claims adjudication for Pune location

Walk in Interview details :

Date - 22-Aug-26 (Saturday)

Venue - Cognizant, Cluster B, Wing -3 4th Floor, EON IT Park Kharadi Pune

Time - 10:00 AM to 12:30 PM

Document to carry - 2 Hardcopy of CV, Govt id card (Aadhar, PAN or Voter)

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Location: Pune
Work Model: Hybrid
Shift: Fixed Night Shift (No Rotation) | 7:00 PM IST to 5:00 AM IST
Experience: 2+ Years Mandatory in US Healthcare Claims Adjudication using Facets Platform

Job Summary

US Healthcare Claims Adjudication Professionals with a minimum of 2+ years of hands-on claims processing/adjudication experience. The ideal candidate should possess strong knowledge of healthcare claims lifecycle, policy interpretation, benefits administration, and claims pricing methodologies. Experience working on the Facets platform is highly preferred.

Key Responsibilities

• Adjudicate medical claims accurately in accordance with client policies, benefit plans, pricing methodologies, and regulatory guidelines.
• Review claim details including member eligibility, provider information, authorization requirements, diagnosis, and procedure codes.
• Analyze and resolve claim edits, denials, pends, and exceptions within established turnaround times.
• Process professional, institutional, and ancillary claims while maintaining quality and productivity standards.
• Research and interpret benefit plans, contracts, reimbursement methodologies, and claims processing guidelines.
• Identify trends, discrepancies, and claim issues, escalating complex cases as appropriate.

Note to be mentioned that copy of this email is mandatory to attend the Interview.