eCOB Specialist I

Elevance Health (Anthem); Louisville (KY); À distance; USD 48 000 - 70 000; Plein temps

Résumé du poste

Elevance Health is seeking an eCOB Specialist I to research and coordinate alternative coverages for company groups and members. The role handles end-to-end COB processes, including claim, membership, and accounting reconciliations, and requires clear communication with carriers and members.

The ideal candidate will interpret complex COB rules, assist with Medicare enrollment when entitled, and maintain accurate system records, balancing multitasking in a fast-paced environment with attention to

Qualifications

• HS diploma or equivalent required; 1 year claims processing and/or customer service experience; 1 year COB experience or equivalent background.
• Knowledge of NAIC & CMS COB guidelines strongly preferred.
• Excellent oral and written communication skills and PC skills are strongly preferred.

Responsabilités

• Research and investigate other coverage for company groups and members; interpret complex rules, laws and contracts.
• End-to-end COB functionality including reconciliation of claim, membership and accounting.
• Identify members enrolled in other coverage using internal queries and external communications.
• Assist members in Medicare enrollment when entitled.
• Update membership system components with investigation results.
• Ensure correct forms for Medicare enrollment are provided.
• Adjudicate impacted claims using COB formulas per state/federal guidelines.

Connaissances

Communication skills

PC skills

Database experience

Formation

HS diploma or equivalent

1 year claims processing experience

1 year COB experience

Outils

Word processing

Spreadsheets

Database system

Description du poste

Anticipated End Date:

2026-10-21

Position Title:

eCOB Specialist I

Job Description:

eCOB Specialist I

Location:

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The eCOB Specialist I is responsible for researching and investigating other coverage for all of the company's groups and members. Performs multi complex functions and interprets complex rules, laws and contracts. Accountable for end-to-end functionality on every Coordination of Benefits (COB) function including reconciliation of claim, membership and accounting.

How you will make an impact:

Utilizes internal queries, internal resource tools, must initiate delicate-in-nature phone calls to other carriers, members, groups, providers, attorneys, CMS and Medicaid and report to identify members who are or should be enrolled in other coverage.

Aides members in enrolling in Medicare when they are entitled.

Updates all of the company's membership system components with investigation results for claim coordination.

Ensures correct forms are provided to assist members enrolling in Medicare.

Reviews claim history to reconcile processed, pended or recovered in any error.

Associate must identify the correct formulas in order to adjudicates impacted claims, using multiple COB Formulas for the various product types, pursuant to State and Federal Guidelines.

Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.

Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.

Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.

Performs other duties as assigned.

Minimum Qualifications:

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 coordination of benefits experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Knowledge of NAIC & CMS COB guidelines strongly preferred.


• WGS experience strongly preferred.


• Excellent oral and written communication skills, PC skills, database system, and related software (word processing, spreadsheets, etc.) strongly preferred.

Job Level:

Non-Management Non-Exempt

Job Family:

CLM > Claims Support

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primar