COB Representative
Site: reputed company Holding Company, Inc.
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.
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.Remote399 reputed company Drive40RegularDay (reputed company of America)8925 reputed company 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.
Apply To This Job
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.
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.
Job reputed company
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
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay reputed company
$22.22 - $31.71/reputed company
Grade
4
EEO Statement:
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.