eCOB Specialist I

1 month ago

Palo Alto, California, United States Elevance Health Full time

eCOB Specialist I

Location : Remote, within 50 miles of an Elevance Health pulse point.

Hours: Monday - Friday, 8 am - 4:30 pm

The eCOB Specialist I is responsible for researching and investigating other coverage for all of the company's groups and members. Performs multi complex functions and interprets complex rules, laws and contracts. Accountable for end-to-end functionality on every Coordination of Benefits (COB) function including reconciliation of claim, membership and accounting.

How you will make an impact:

  • Utilizes internal queries, internal resource tools, must initiate delicate-in-nature phone calls to other carriers, members, groups, providers, attorneys, CMS and Medicaid and report to identify members who are or should be enrolled in other coverage.
  • Aides members in enrolling in Medicare when they are entitled.
  • Updates all of the company's membership system components with investigation results for claim coordination.
  • Ensures correct forms are provided to assist members enrolling in Medicare.
  • Reviews claim history to reconcile processed, pended or recovered in any error.
  • Associate must identify the correct formulas in order to adjudicates impacted claims, using multiple COB Formulas for the various product types, pursuant to State and Federal Guidelines.

Minimum Requirements:

  • Requires a HS diploma or equivalent and a minimum of 1 year of claims processing and/or customer service and a minimum of 1 year coordination of benefits experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

  • Knowledge of NAIC & CMS COB guidelines strongly preferred.
  • Excellent oral and written communication skills, PC skills, database system, and related software (word processing, spreadsheets, etc.) strongly preferred.

* For candidates working in person or remotely in the below locations, the salary range for this specific position is $19.04 to $34.27

Locations : California; Colorado; District of Columbia; Hawaii; Nevada; New York; Washington State

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

  • The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

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