Industries
Healthcare
Business process services
Modern AI-integrated
healthcare operations
The playbook for growth is being rewritten. We believe the future belongs to the modern enterprise that embraces AI-integrated business operations—a business that can anticipate and act instantly to boldly seize opportunities amid rapid change.
Innovative partnerships are essential for payers, providers and pharmacy benefits managers to succeed in the competitive healthcare field. We help clients rethink how they create value, innovate and grow by combining business and process expertise in the medical field with intelligent digital platforms to optimize business operations.
MetroHealth and Cognizant partnership in healthcare
MetroHealth’s investments in Cognizant Revenue Cycle Management are driving positive results increasing productivity by 8% in the last year and average daily collections by 25%. The services are built around a proprietary Unified Single Platform (USP), a performance improvement engine and a cloud-based technology platform that continuously deploys automation and innovation to improve quality and financial outcomes. The solution also includes an ARM tool to prevent claim denials on the front end by identifying the root causes of initial claim rejections, avoidable and non-avoidable. The tool can categorize the denials down to the department level, so we can identify trends and use that information to educate and train our staff. Since implementation, denials have decreased by 30%, which translates into $13M in additional revenue.
MetroHealth and Cognizant have a long-standing strong partnership and we continue to work together to reduce denials/accounts receivable and increase cash collections.
Healthcare BPS and automation services
Enrollment and member services
Our member enrollment, premium billing, reconciliation, and onboarding services put members at the center, ensuring a seamless experience across their multiple touch points. Our solutions in benefits configuration simplify complex structures and improve efficiency.
Provider data management (PDM)
Industry leading capabilities, from provider credentialing to contract loading and provider data management, our solutions ensure data accuracy. With Cognizant, payers can create comprehensive PDM strategies that focus on four components: single source of truth, data governance, bidirectional integration, and end-to-end platform. We help you structure your processes knowing that PDM is a journey, rather than a one-time initiative.
Claims administration
With deep understanding of claims processing—from front-end operations, claims adjudication and appeals to supporting Special Investigation Units (SIU). Our integrated solutions ensure accurate and timely payments, reducing interest payouts and penalties
Clinical support services
Cognizant’s care management services can help payers gain access to certified and experienced talent pools globally. Our delivery teams offer expertise in utilization management, case management, and population health management—helping clients deliver improved clinical outcomes.
Customer experience management
Contact center services provide payers with digital transformation solutions that improve member and provider experience. Our services support members and providers with omni-channel contact services designed to improve customer satisfaction (CSAT) and NPS scores.
Full cycle RCM
RCM gives an intuitive edge to the healthcare industry. From scheduling and registration to payment posting, we handle end-to-end revenue cycle management services for hospitals and physician practices. With proprietary RCM workflow technology, we help you maximize efficiency and improves cash flow with digitized management.
Front-end RCM
Our complete suite of patient access and engagement includes registration, scheduling, remote patient monitoring, discharge planning, health risk assessments, and wellness and lifestyle coaching. Improving these areas enables providers to embrace a digital-first, intuitive operating model—leading to fast, easy and safe experiences for their patients.
Middle office RCM
Provides customized coding and charge master services for any size or type of organization, from physician practices to hospitals. We leverage the latest RCM technologies to expedite and automate processes that help reduce errors and increase claim submission rates. Our fully outsourced mid-cycle RCM services will help you scale fast.
Back office RCM
Our account receivables service combines skilled professionals and proprietary technology to resolve accounts through all revenue streams. Established workflows, multi-channel outreach and financial assistance programs maximize revenue and recovery.
Complex claims
We can help healthcare organizations overcome growing reimbursement complexities and optimize revenue. With expertise and innovative technology, we identify the proper workers’ compensation and third-party liability carriers to ensure claims are paid in accordance with state regulations.
Clinical administration services
Our clinical administrative services focus on improving patient experience and quality of care. You’ll gain a competitive edge with our robust set of services—utilization management, bill review, record retrieval, gaps identification and physician training. Our resources include 350+ USRNs (registered nurses) and 700+ certified specialists.
Claims services
We offer a flexible pharmacy claims processing platform along with efficient distribution management services for employers and third-party administrators—enabling them to improve processes while controlling prescription costs.
Benefits configuration
Workflow extracts and consolidates information across all departments of the pharmacy benefit managers (PBM), providing plan sponsors with a 360° patient view that enhances critical health and financial decision-making resulting in best outcomes. We provide Day 1 assurance of correct adjudication outcomes, along with complete and accurate eligibility, prior authorization, accumulator and claim history data.
Frontend mailroom services
Enables modern operations by leveraging a data platform for order intake, a centralized workflow for prescription filling, a call center to support mail-order pharmacy services, and access to physicians’ offices to obtain prescription refills or to verify information.
Mail order processing
Our services include intuitive digital tools to analyze medication requests and calculate the urgency of the treatment—reducing errors and improving efficiency. To speed up order fulfillment, our workflow platform accounts for tracking, verification, approvals, follow-ups and on-time delivery.
Intelligent automation services
Advisory services
Accelerate. Simplify. Scale.
Intelligent automation requires equal focus on people and technology. Our advisory team works with you to create a sustainable framework to enable scale, establishing the right operating model and embedding change management. With in-depth domain expertise, offerings and data-driven methodology, we work with you to modernize business processes that deliver results.
We bring unique and compelling perspectives of the technology landscape. Our technology office has deep and broad expertise across domains to create a holistic, best-fit set of solutions to accelerate your digital transformation journey. Their insights help you navigate a quickly evolving landscape with ease and speed.
RVT solutions
Reimagine work, engineer digital
Achieving maximum business results with intelligent process automation requires enterprise-wide digital operations using technology that’s uniquely designed for your IT ecosystem. Our proprietary and partner solutions help you simplify, accelerate and expand automation—enabling end-to-end processes to create flexible, resilient operating models.
By combining the power of industry tools with lifecycle accelerators that deliver a future-proof platform, we help you democratize automation technologies across business and operations teams. Using low-code solutions, task capture, process discovery and cognitive platforms across processes, you can move past employee “busy work” and drive true business innovation.
Implementation services
Optimal results delivered the way you work
Intelligent process automation success hinges on two must-haves: the right technology and a partner who immerses into the fabric of how you work. We focus on providing flexible, right-fit, customized solutions that support a non-linear approach to digital transformation. Our implementation model delivers with quality, utilizing change management to bolster outcomes.
With our platform approach, we integrate interconnected technologies to speed automation, optimize delivery and improve repeatability and scalability while ensuring resiliency. Our frameworks, accelerators and domain-specific assets help you achieve value faster. We enable citizen development strategies ranging from targeted groups to full scaled deployments.
Managed services
Modern operating models
Your organization exists to serve customers well—understanding their needs and moving quickly to meet their demands. We exist to help you do that. Through fully managed outsourced automation services, we provide flexibility in managing and scaling process innovation, partnering with your IT and business functions to deliver innovation through IP, technology and alternative talent models.
We can handle documentation, development, deployment and maintenance of process automation on your behalf and offer services in an outcome-based model. We provide sustainable business.
Finance & accounting
Boost business performance with the power of AI
Leading finance and accounting (F&A) organizations can achieve business outcomes amid disruption through adaptive solutions tailored to the business. A modern F&A organization is enriched through intelligent decision-making, automation of business processes and highly experienced global talent that together deliver agility, scalability and resiliency. Cognizant provides AI-integrated F&A solutions that drive better business decision-making using analytics and insights while enabling rapid technology and process integration from mergers and acquisitions.
Omnichannel customer care
Make every customer interaction count
Consumer expectations of interactions with brands have radically changed. Simplicity, personalization and speed are now table stakes, and companies unable to deliver are at risk of losing shares to savvier competitors. Modern businesses offer intuitive interactions that are based on insights and technology-fueled processes. They integrate context, sentiment and intent-based analytics into their omnichannel customer care strategy. Using AI, analytics and human ingenuity, they enable consistent, personalized experiences that increase customer satisfaction and help grow revenue
Candidates
Modern candidates
Today’s candidates expect a seamless, engaging onboarding experience. They want to use hassle-free intuitive systems that make it easy to assimilate into the organization and culture.
Before employees leave an organization or retire, they expect to be treated well throughout their career. They want to be provided opportunities aligned to their aspirations, learning avenues that set them up for success and rewards that are proportionate to their efforts.
Managers
Strategic managers
Today’s successful managers have a full view into their team’s productivity, to enable good connection and accountability. Digital tools that support decision-making are key to meeting day-to-day needs. Also, a robust framework of policies and processes helps managers focus in on prioritized work.
HR business partners
Collaborative HR
HR business partners can increase their efficiency using digital systems that automate processes and keep administrative tasks to a minimum. This allows time to work and collaborate with business stakeholders to create and execute talent strategy—and with employees to help them pursue and meet their career goals.
Leadership
Effective leaders
Effective leadership needs talent insights on the go, to support robust decision making that is aligned to the needs of the talent.
Take the first step
Serving customers by looking forward as well as back is a big promise, but the power of today’s new digital capabilities is vast and growing.
Let’s talk about how automotive digital solutions can work for your business.