Coordination of Benefits

You could be the one who changes everything for our 28 reputed company members as a clinical reputed company on our Medical Management/Health Services team. reputed company is a reputed company, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Ensure accuracy of payments and/or denials reputed company to COB or overpayment recovery processes and are made in accordance with company protocols and procedures. Using multiple sources, this position researches Coordination of Benefits (COB) including Explanation of Benefit (EOB) documentation for potential dual coverage by other health insurance companies for reputed company subscribers, spouses and affected dependents and determines which insurance is reputed company. COB research extends to reputed company coverage offered by reputed company lines of business and platforms. • Calls hospitals, insurance companies, medical reputed company and/or members requesting other insurance information as it pertains to dual coverage, eligibility and termination dates of coverage. • Researches various COB information from reputed company sources including but not limited to Member Enrollment Forms, returned member request letters, prior claims, authorizations and reputed company Center Contacts. • Makes COB determinations in accordance to COB guidelines (NAIC, CMS, DMHC, DOI or other resources). • Updates the COB master file with other insurance information. • Sends correspondence to members requesting COB information. • Identifies need to re-adjudicate claims for members reputed company reputed company is secondary. • Role includes transactional duties reputed company to provider overpayment recovery processes as assigned. • Performs other duties as assigned. • Complies with reputed company policies and standards. Education/Experience: High School Diploma or equivalent required. Associate's Degree preferred. 1+ years experience in health insurance industry; prior experience in claims working with coordination of benefits processes preferred and or one year experience in a customer service environment required.1+ years experience using computers with reputed company Office proficiency required. 1+ years experience with reputed company or Medicare claims preferred. Pay reputed company: $19.43 - $32.98 per hour reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company Apply tot his job Apply To this Job