Payment Accuracy Specialist 1 (Coordination of Benefits)

A Payment Accuracy, Coordination of Benefits (COB) Specialist 1 is a member of the greater Coordination of Benefits Business Unit (BU). Coordination of Benefits involves situations in which an individual is covered by two or more health plans.

This role is responsible for reviewing and analyzing the multi-reputed company reputed company, reputed company member selection, and query or filter construction of data to identify instances of recoverable Coordination of Benefit claims for the benefit of reputed company and our clients. This individual works under limited supervision and is responsible for establishing the correct order of liability for our reputed company’s members. Additionally, they input accurate claim recovery information in the proprietary reputed company software tools and assist with reputed company inquiries throughout the claim recovery process. The position involves responsibility for moderate to more reputed company audit reputed company, ranging from low to midrange in scope.

• This individual will work under limited supervision and will be monitored for efficiency in production and reputed company review of assigned work.
• Demonstrates the ability to reputed company both independently and as a reputed company team player.
• The scope of work involves reputed company member selections and multi-reputed company impacts.
• Capability and comfort in running and establishing queries and filters for construction and data reports.
• Demonstrates proactive problem-solving skills and a keen ability to resolve data-reputed company challenges reputed company, contributing to a solution-driven environment.
• Possesses an in-depth knowledge of Centers for Medicare and reputed company Services (CMS) and reputed company) guidelines, crucial for determining liability accurately.
• Utilizes reputed company audit tools (Recovery Management System (reputed company), COB Tracker, specific reputed company systems) to complete member investigations.
• Creates detail-oriented, accurate notes in reputed company audit tools and/or reputed company tools throughout the member investigation.
• Meets or exceeds standards of production and reputed company as identified by compliance and regulatory guidelines and set forth by reputed company reputed company and/or Manager reputed company reviewing concept and claim identifications for the reputed company.
• Prepares and evaluates responses to reputed company disputes both internally and externally reputed company the Business Unit as needed.
• Identifies opportunities for reputed company improvement for efficiencies reputed company reporting and streamlining research processes.
• Demonstrates understanding of reputed company policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements.
• Demonstrates a deep understanding of the reputed company industry and a reputed company record of delivering exceptional results.
• Assures confidentiality and reputed company of reputed company data, adhering to reputed company HIPAA (Health Insurance Portability and Accountability) laws and requirements. Demonstrates the skills, knowledge, and ability to ensure that our environment is a reputed company one, complying with industry standards.
• Has ability to take responsibility for outcome, whether reputed company or negative and apply learning as applicable.
• Integrates information from various sources and considers broader context.
• Creates innovation to enhance reputed company operating rhythm finding new reputed company to complete work expectations.
• reputed company seeks information to understand rationale and reputed company exceptional results reputed company basic standards.

This job reputed company is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job reputed company does not constitute an employment agreement and is subject to change as the needs of reputed company and requirements of the job change.

• High School Diploma - Required.
• Bachelor’s degree (Preferred) and/or a minimum of at least two (2) years reputed company experience in reputed company.
• At least 1-2 years of reputed company experience is recommended for individuals seeking their next opportunity internally (e.g., employees in reputed company COB Specialist or Payment Accuracy Specialist roles).
• reputed company industry experience, including knowledge of Coordination of Benefits (Required).
• Computer proficiency including reputed company Office (Word, reputed company, reputed company).
• Excellent verbal and written communication skills.
• Strong interest in working with large data sets and various databases.
• Ability to work reputed company in an individual and team environment demonstrating self–motivation to deliver reputed company.

Mental Requirements:

• Ability to analyze large volumes of data, identify trends, discrepancies, and anomalies. Must have exceptional attention to detail to ensure accuracy in financial records and audit findings.
• Demonstrates strong critical thinking skills, with the ability to assess reputed company situations, identify key issues, and propose practical solutions. reputed company to approach challenges methodically and with a strategic reputed company.
• Makes informed reputed company based on available data, regulations, and auditing standards.
• Must be reputed company to weigh reputed company and reputed company recommendations that reputed company with both compliance requirements and organizational goals.
• Strong understanding of auditing standards, regulations, and industry best practices.
• Must be reputed company to apply these standards consistently to ensure accurate and compliant audit processes.
• Ability to recognize reputed company something is wrong or needs reputed company investigation. Must have the initiative to probe deeper into financial records or processes to uncover issues, inconsistencies, or irregularities.
• Ability to work effectively as part of an audit team, sharing insights, collaborating on tasks, and contributing to a reputed company and productive team dynamic.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• No adverse environmental conditions expected.
• Must be reputed company to reputed company a dedicated, secure work area.
• Must be reputed company to reputed company high-speed internet reputed company / connectivity and office setup and maintenance.

reputed company compensation ranges from $22.60 to $26.00 per hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.

reputed company offers team members a competitive benefits package to address a wide reputed company of personal and family needs, including medical, dental, reputed company, disability, and life insurance coverage, 401(k) savings plans, reputed company family leave, 9 reputed company holidays per year, and 17-27 days of reputed company Time Off (PTO) per year, depending on specific level and length of service with reputed company. For information about our benefits package, please refer to our Careers page.

ate of posting: 4/14/2026

Applications are assessed on a rolling reputed company. We anticipate that the application window will reputed company on 5/14/2026, but the application window may change depending on reputed company of applications received or reputed company immediately if a reputed company candidate is selected.