Remote COB Claims Specialist

Mass General Brigham; United States; Remote; USD 31,000 - 44,000; Full time

Job summary

Mass General Brigham Health Plan is seeking a COB Claims Processor to identify recovery opportunities and resolve complex COB-related inquiries for members with other insurance. This remote role supports accurate processing and timely communication with internal teams.

The ideal candidate has 2–3 years of COB or third-party liability experience, strong customer service, and knowledge of medical terminology. The position offers standard business hours and comprehensive benefits.

Qualifications

• 2-3 years of COB/third-party liability experience in healthcare required.
• Knowledge of medical terminology and Medicare/claims processes preferred.
• Strong communication and customer service skills essential.

Responsibilities

• Identify recovery opportunities within the COB department.
• Review, research, and process COB claims for members with other insurance.
• Reprocess COB claims for COB-terminated members and maintain accurate data in QNXT.
• Resolve email inquiries from internal customers regarding members’ claims or eligibility updates.
• Handle MSP cases per Medicare guidelines and communicate case status to team and Sales as needed.
• Coordinate recoveries with other insurers per federal regulations.
• Process Credit Balance claims, refund checks, and validate retractions.
• Determine primary insurance by reviewing COB questionnaires in accordance with federal/state mandates.

Skills

Customer service

Medical terminology

Communication

Organization

Problem solving

Education

High School Diploma or Equivalent

Tools

QNXT

Job description

Mass General Brigham Health Plan is seeking a COB Claims Processor to identify recovery opportunities and resolve complex COB-related inquiries for members with other insurance. This remote role supports accurate processing and timely communication with internal teams.

The ideal candidate has 2–3 years of COB or third-party liability experience, strong customer service, and knowledge of medical terminology. The position offers standard business hours and comprehensive benefits.