eCOB Specialist I

1 month ago

Tampa, Florida, United States Elevance Health Full time
Job Description

eCOB Specialist I

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

Hours: Monday - Friday, an 8 hour shift between the hours of 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 claims, membership, and accounting.

Key Responsibilities

  • Utilizes internal queries, internal resource tools, and initiates delicate-in-nature phone calls to other carriers, members, groups, providers, attorneys, CMS, and Medicaid 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.
  • Associates must identify the correct formulas to adjudicate impacted claims, using multiple COB formulas for the various product types, pursuant to State and Federal Guidelines.

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.

Compensation and Benefits

The salary range for this position is $19.04 to $34.27. Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (all benefits are subject to eligibility requirements).

Work Environment

Elevance Health operates in a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

Equal Employment Opportunity

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.

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