eCOB Specialist II: Newborn Benefits (Remote)

Anthem Blue Cross & Blue Shield; Columbus (GA); Híbrido; USD 60.000 - 90.000; Jornada completa

Descripción de la vacante

Elevance Health is seeking an eCOB Specialist II focused on newborn benefits to review coverage options and coordinate COB processes. This role emphasizes research, cross-functional collaboration, and adherence to state and federal guidelines.

The candidate will work within a hybrid model, handling complex COB rules, Medicare enrollment support, and accurate claim reconciliation while maintaining exceptional member service.

Formación

• Requires a HS diploma or equivalent and a minimum of 2 years of claims processing and customer service and 2 years COB experience that required using NAIC & CMS COB guidelines.

Responsabilidades

• Research and investigate other coverage for company groups and members across multiple platforms.
• Initiate delicate inquiries to carriers, members, groups, providers, attorneys, CMS and Medicaid to identify enrollment opportunities.
• Determine primacy on each case using NAIC, CMS rules and member benefits.
• Update membership systems with investigation results for claim coordination.
• Provide forms to assist members enrolling in Medicare.
• Review claim history to identify reconciliations and errors for recovery.
• Identify correct formulas to adjudicate impacted claims using COB rules for product types.
• Handle calls, texts, faxes, and electronic queues while taking notes and speaking with customers.

Conocimientos

COB knowledge

Claims processing

Customer service

Educación

HS diploma or equivalent

Descripción del empleo

Elevance Health is seeking an eCOB Specialist II focused on newborn benefits to review coverage options and coordinate COB processes. This role emphasizes research, cross-functional collaboration, and adherence to state and federal guidelines.

The candidate will work within a hybrid model, handling complex COB rules, Medicare enrollment support, and accurate claim reconciliation while maintaining exceptional member service.