Remote eCOB & Medicare Claims Specialist II

Elevance Health (Anthem); Atlanta (GA); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Medical

Dental

Vision

Incentive bonus programs

Job summary

Elevance Health is seeking an eCOB Specialist II to research and manage other coverage for company groups and members. You will oversee end-to-end coordination of COB functions, including claim, membership, and accounting reconciliation, across multiple platforms.

You will use state and federal rules to determine primacy, contact carriers and members, and update systems with investigation results while supporting Medicare enrollment when entitled.

Qualifications

• 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; or any combination of education and experience which would provide an equivalent experience.

Responsibilities

• Research and investigate other coverage for company groups and members across multiple platforms.
• Perform end-to-end COB functionality including reconciliation of claim, membership and accounting.
• Initiate delicate-in-nature calls to carriers, members, groups, providers, attorneys, CMS and Medicaid to identify enrollment.
• Assist members in enrolling in Medicare when entitled.
• Determine primacy using complex state and federal rules (CMS, NAIC) and member benefits.
• Update membership system components with investigation results for claim coordination.
• Provide forms and guidance to help members enroll in Medicare.
• Identify claims requiring reconciliation and apply COB formulas per guidelines.
• Multitask across calls, texts, faxes, and electronic queues while taking notes and talking with customers.

Skills

Claims processing

Customer service

COB rules knowledge

Education

HS diploma or equivalent

Tools

NAIC & CMS COB guidelines

Job description

Elevance Health is seeking an eCOB Specialist II to research and manage other coverage for company groups and members. You will oversee end-to-end coordination of COB functions, including claim, membership, and accounting reconciliation, across multiple platforms.

You will use state and federal rules to determine primacy, contact carriers and members, and update systems with investigation results while supporting Medicare enrollment when entitled.