COB Specialist I: Medicare & Claims Coordination

Elevance Health; Miami (FL); Hybrid; USD 55.000 - 75.000; Vollzeit

Zusammenfassung

Elevance Health is seeking an eCOB Specialist I in Florida to research and investigate other coverages for all company groups and members, performing end-to-end COB functions including reconciliation of claims, membership, and accounting.

The role requires strong analytical skills to interpret complex COB rules, laws, and contracts, with the ability to multitask in a fast-paced environment and communicate effectively with carriers, members, providers, attorneys, CMS, and Medicaid.

Qualifikationen

• 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 COB experience.
• Ability to interpret complex rules, laws and contracts within COB.
• Strong communication and problem-solving skills, with attention to detail.

Aufgaben

• Identify members who should be enrolled in other coverage using internal tools and outreach.
• Assist members in enrolling in Medicare when entitled.
• Update membership systems with investigation results for claim coordination.
• Ensure correct forms are provided to assist Medicare enrollment.
• Adjudicate impacted claims using COB formulas per state/federal guidelines.
• Handle calls, texts, and inquiries while taking notes and talking to customers.

Kenntnisse

Claims processing

Customer service

COB coordination

CMS COB guidelines

WGS experience

Ausbildung

HS diploma or equivalent

Jobbeschreibung

Elevance Health is seeking an eCOB Specialist I in Florida to research and investigate other coverages for all company groups and members, performing end-to-end COB functions including reconciliation of claims, membership, and accounting.

The role requires strong analytical skills to interpret complex COB rules, laws, and contracts, with the ability to multitask in a fast-paced environment and communicate effectively with carriers, members, providers, attorneys, CMS, and Medicaid.