Coordination of Benefits Processor (Managed Care) Remote

Molina Talent Acquisition; Long Beach (CA); A distancia; USD 28.000 - 41.000; Jornada completa

Descripción de la vacante

Molina Healthcare is seeking a Coordination of Benefits Processor for remote work, based anywhere in the United States. The role focuses on coordinating benefits across carriers, reviewing EOBs, and maintaining COB records to ensure accurate member coverage.

The ideal candidate brings strong MS Office skills, high attention to detail, and the ability to collaborate across a matrixed healthcare organization. PST time zone familiarity is preferred and benefits are provided.

Formación

• 1 year of administrative support experience or equivalent
• Attention to detail, organizational and time-management skills
• Ability to work cross-collaboratively across a highly matrixed organization
• Effective verbal and written communication skills
• Proficiency with Microsoft Office suite and related software programs

Responsabilidades

• Coordinate COB reviews and validate COB information across carriers
• Process EOBs, medical claims and eligibility to determine COB actions
• Maintain COB databases and CMS records for accurate member coverage
• Communicate with CMS and provider portals to update COB information
• Support COB team with data entry and administrative tasks

Conocimientos

MS Office Suite

Attention to detail

Time-management

Verbal & written communication

Cross-functional collaboration

Herramientas

CMS portals

Provider portals

Descripción del empleo

Coordination of Benefits Processor (Managed Care) Remote

Long Beach, CA, United States and 1 more

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Job Description

Molina Healthcare is hiring for Coordination of Benefits Processor. This role is remote and can be worked from a variety of locations. PST Time Zone is preferred.

This role will provide support for coordination of benefits review activities that directly impact medical expenses and premium reimbursement. Responsible for primarily coordinating benefits with other carriers responsible for payment. Facilitates administrative support, data entry, and accurate maintenance of other insurance records.

• Solid experience with the MS Office Suite
• High attention to detail
• Supports multiple Lines of Business (LOBs), including Medicare and Marketplace (MKP)
• Validates external medical and pharmacy coverage through provider portals, outbound calls, and review of Explanation of Benefits (EOBs) to identify and verify other insurance information.
• Researches and validates state, vendor, and internal Coordination of Benefits (COB) leads through insurance carrier outreach and online resources.
• Reviews and interprets EOBs, medical claims, and eligibility information to determine appropriate COB actions.
• Processes provider disputes and submits claim adjustments to ensure claims are paid correctly based on validated COB information.
• Maintains Internal databases and other insurance records to ensure accurate member coverage information.
• Submits ECRS requests to CMS to update external coverage information within the CMS system.
• Maintains compliance with departmental procedures, documentation standards, and regulatory requirements related to COB and Medicare coordination.
• Provides telephone, administrative and data entry support for the coordination of benefits (COB) team.
• Phones or utilizes other insurance company portals to validate state, vendor and internal COB leads.
• Updates the other insurance table on the claims transactional system and COB tracking database.
• Contacts Centers for Medicare and Medicaid Services (CMS) directly, or coordinates with the assigned company contact to log tickets for premium restoration such as Medicare Secondary Payer (MSP) and End-Stage Renal Disease (ESRD). Job Requirements
• At least 1 year of administrative support experience, or equivalent combination of relevant education and experience.
• Attention to detail, organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
• Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications Health care experience.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Same Posting Description for Internal and External Candidates

Job Info

• Job Identification 2039032
• Job Category Operations
• Posting Date 09/17/2026, 06:29 PM
• Job Schedule Full time
• Locations Long Beach, CA, United States United States
• Salary Range $20.34 - $30.39 Hourly *Actual compensation may vary based on geographic location, work experience, education and/or skill level