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Anthem, Inc eCOB Specialist I - Remote (OH, GA, KY, IN, VA, NY, MO, WI) - PS19963 in Lexington, Kentucky

eCOB Specialist I - Remote (OH, GA, KY, IN, VA, NY, MO, WI) - PS19963

Location: Ohio, United States

New

Field: Claims

Requisition #: PS19963

Post Date: 2 days ago

Your Talent. Our Vision . At Anthem, Inc. , it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

eCOB Specialist I

Location : This is a remote (work-from-home) opportunity, but you must currently reside in one of the following states – Ohio, Indiana, Kentucky, New York, Virginia, Georgia, Wisconsin, Missouri

Hours : Monday through Friday, day shift

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.

Primary duties may include, but are not limited to:

  • 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.

Qualifications:

  • Requires a HS diploma or equivalent;

  • 1 year of claims processing and/or customer service skills and 1-year coordination of benefits experience;

  • Or, any combination of education and experience, which would provide an equivalent background.

  • Requires knowledge of NAIC & CMS COB guidelines; excellent oral and written communication skills and skill in using PC, database system, and related software (word processing, spreadsheets, etc.).

  • Must be an independent thinker and have the ability to work with little supervision

  • WGS and NASCO systems experience preferred

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com An Equal Opportunity Employer/Disability/Veteran

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