Remote COB Specialist I: Claims & Coordination

Elevance Health; Tampa (FL); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Elevance Health is seeking an eCOB Specialist I to research and investigate alternative coverages for members and groups. The role handles end-to-end COB functions, including claim, membership, and accounting reconciliation.

Key tasks include initiating delicate calls to carriers, members, providers, and CMS; updating systems with investigation results; and applying COB formulas to adjudicate claims. A structured schedule with overtime may apply.

Qualifications

• HS diploma or equivalent and at least 1 year of claims processing and/or COB experience.
• Ability to multitask in a fast-paced environment with strong attention to detail.
• Excellent oral and written communication skills; proficient with standard software tools.

Responsibilities

• Identify members who should be enrolled in other coverage using internal queries and reports.
• Assist members with Medicare enrollment when entitled.
• Update membership systems with investigation results for COB coordination.
• Review claim history to reconcile processed, pended, or recovered claims.
• Adjudicate impacted claims using COB formulas compliant with state and federal guidelines.

Skills

Claims processing

Coordination of Benefits

Communication skills

PC skills

Education

HS diploma or equivalent

Tools

NAIC & CMS COB guidelines

Job description

Elevance Health is seeking an eCOB Specialist I to research and investigate alternative coverages for members and groups. The role handles end-to-end COB functions, including claim, membership, and accounting reconciliation.

Key tasks include initiating delicate calls to carriers, members, providers, and CMS; updating systems with investigation results; and applying COB formulas to adjudicate claims. A structured schedule with overtime may apply.