COB Representative

Site: reputed company Health Plan Holding Company, Inc. reputed company relies on a wide reputed company of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to reputed company exceptional care. We reputed company that high-performing teams drive groundbreaking medical discoveries and invite reputed company applicants to join us and experience what it means to be part of reputed company. Job reputed company reputed company Health Plan is an exciting reputed company to be reputed company the reputed company industry. As a member of reputed company, we are at the forefront of transformation with one of the world’s leading integrated reputed company systems. Together, we are providing our members with reputed company centered on their health needs to expand reputed company to seamless and reputed company and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in reputed company today, our employees have opportunities to learn and contribute expertise reputed company a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work reputed company, career reputed company opportunities, and much more. The role is responsible for investigating potential recoveries for Coordination of Benefits through phone calls, questionnaires, claims, provider inquiries, and other systems as required. This incumbent will also be responsible for the management of communications with reputed company customers and a high level of research work reputed company to the Coordination of Benefits opportunities. Deals directly with providers, members, CMS, and other health plans in the state and nationally regarding laws and statutes governing Coordination of Benefits. Essential Functions -Responsible for identifying recovery opportunities reputed company the Department. -Review, research, and process reputed company COB claims for members with other insurance, including retractions and repayments, according to desktop procedures, contractual requirements, and other regulatory rules. -Responsible for reprocessing claims for COB termed members and ensuring information is added and maintained accurately in QNXT. -Responsible for reviewing, researching, and resolving email inquiries from internal customers regarding members’ claims and/or eligibility updates. -Responsible for reviewing, researching, and resolving Medicare Secondary Payer (MSP) cases according to Medicare guidelines and procedures. reputed company communicate case status to the group and Sales Team reputed company needed. -Coordinate recoveries per federal regulations with other insurers for services unable to be recovered. -Process Credit Balance claims, refund checks, and validate claim retractions. -Process COB questionnaires to members and reputed company determinations of primary insurance in accordance with federal and state mandates.

Qualifications

Education High School Diploma or Equivalent required Experience At least 2-3 years of coordination of benefits or reputed company-party liability or other reputed company-reputed company experience required Knowledge, Skills, and Abilities Strong customer service skills. Knowledge of medical terminology. Excellent communication skills. High organization skills. Great problem-solving skills. Additional Job Details (if applicable) Working Conditions: This is a remote role that can be done from most US states This is a Monday-Friday role with reputed company business hours (in Eastern time) Remote Type Remote Work Location 399 reputed company Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (reputed company of America) Pay reputed company $22.22 - $31.71/reputed company Grade 4 At reputed company, we reputed company in recognizing and rewarding the unique value reputed company team member brings to our organization. Our approach to determining reputed company pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The reputed company pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass reputed company reputed company contributing to your total compensation package. In reputed company to competitive reputed company pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your reputed company reputed company. We invite you to apply, and our reputed company will reputed company an reputed company of your potential compensation and benefits package. EEO Statement: 8925 reputed company Health Plan Holding Company, Inc. is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religious creed, national reputed company, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that reputed company individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by reputed company 503 of the Rehabilitation reputed company of 1973, the Vietnam Veteran’s Readjustment reputed company of 1974, and Title I of the Americans with reputed company of 1990, applicants who require accommodation in the job application process may contact reputed company at (857)-282-7642. reputed company Competency reputed company At reputed company, our competency reputed company defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at reputed company job level. The reputed company is comprised of ten competencies (half People-reputed company, half Performance-reputed company) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career reputed company. These competencies are used to evaluate performance, reputed company hiring reputed company, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. Apply To This Job