About Us
Cognet HRO
is a leading Business Process Outsourcing Services Company providing full range of
HR and F&A;
services to
US based clients ,
With over 17 years of rich experience in
Payroll Tax, Benefits S & HR Administration, Finance & Accounting , Sales Support
.
CogNet
has been serving the PEO, ASO, HRO and HR Technology spaces since our inception. We help organizations extend their capabilities through simplified implementation, productivity performance measured to the minute, easy collaboration, and transparent pricing built around real time utilization. Our extensive expertise, data library, and workflow development tools accelerates the client implementation process .We have developed a deep expertise of process and technology in our Services , which allows us to rapidly deliver value to our clients.
Cognet
has been delivering outsourced solutions to the clients around the Globe.

Job Description
US Healthcare Claims Adjudication – Senior Process Associate
Job Title
Senior Process Associate

Experience Required
4 – 6 Years

Timing
6:30 pm - 3:30 am





Job Summary
We are looking for an experienced US Healthcare Claims Adjudication Specialist with strong knowledge in end-to-end claims processing and payer guidelines. The candidate will be responsible for adjudicating medical claims accurately while ensuring compliance with CMS, HIPAA, and client-specific policies.

Key Responsibilities
- Perform end-to-end US healthcare claims adjudication.
- Verify member eligibility and advantages based on Date of Service (DOS).
- Apply CPT, ICD-10, HCPCS, and payer adjudication rules accurately.
- Process authorization, corrected, and duplicate claims.
- Handle COB (Coordination of Benefits) and multi-insurance claims processing.
- Review and manage denials, appeals, and claim reprocessing activities.
- Calculate deductibles, copay, coinsurance, and out-of-pocket responsibilities accurately.
- Identify non-covered services, exclusions, accident claims, and policy limitations

📌 Senior Process Associate (Ambattur)
🏢 CogNet
📍 Ambattur