Reinsurance Specialist jobs in Duluth, MN

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eCOB Specialist I

Job Family : CLM >

Claims Support

Type : Full time

Date Posted : Apr 18, 2024

Anticipated End Date : May 03, 2024

Reference : JR111486

Location : VA, NORFOLK

VA, NORFOLK

PA, SEVEN FIELDS

VA, ARLINGTON

FL, MIAMI

MA, BOSTON

IN, INDIANAPOLIS

OH, CINCINNATI

VA, RICHMOND

CT, ROCKY HILL

CA, RANCHO CORDOVA

NE, LINCOLN

TN, BRENTWOOD

DC, WASHINGTON

NV, LAS VEGAS

MN, MENDOTA HEIGHTS

TN, KNOXVILLE

MO, COLUMBIA

VA, ASHBURN

OH, COLUMBUS

NC, CARY

WA, LAKEWOOD

WI, MADISON

WV, CHARLESTON

DE, WILMINGTON

OH, SEVEN HILLS

ID, MERIDIAN

ID, MERIDIAN

RI, SMITHFIELD

NC, WINSTON

GA, ATLANTA

DC, WASHINGTON

IL, DEERFIELD

FL, TAMPA

FL, ALTAMONTE SPRINGS

FL, TALLAHASSEE

KS, TOPEKA

VA, ROANOKE

NY, Lake Success

CO, COLORADO SPRINGS

FL, JACKSONVILLE

CA, WOODLAND HILLS

NJ, MORRISTOWN

TN, MEMPHIS

OH, MASON

NY, ALBANY

CA, SACRAMENTO

CA, WALNUT CREEK

KY, LOUISVILLE

NH, MANCHESTER

WA, SEATTLE

TX, GRAND PRAIRIE

IL, CHICAGO

TX, AUSTIN

MI, DEARBORN

VA, CHESAPEAKE

TN, NASHVILLE

MN, GILBERT

LA, METAIRIE

NY, MIDDLETOWN

PR, San Juan

IL, SPRINGFIELD

TX, HOUSTON

CT, WALLINGFORD

MO, ST LOUIS

GA, SAVANNAH

CA, COSTA MESA

MD, HANOVER

NJ, ISELIN

CA, CERRITOS

OH, MASON

IL, CHICAGO

CO, DENVER

NV, LAS VEGAS

CA, PALO ALTO

ME, SOUTH PORTLAND

NY, LATHAM

OH, COLUMBUS

HI, KAPOLEI

GA, AUGUSTA

IA, W DES MOINES

MA, WOBURN

MA, NEWTON 55 CHAPEL ST

Description

eCOB Specialist I

Location : Remote, within 50 miles of an Elevance Health pulse point.

The eCOB Specialist I is 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.

How you will make an impact :

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.

Requires a HS diploma or equivalent and a minimum of 1 year of claims processing and / or customer service and a minimum of 1 year coordination of benefits experience;

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

Preferred Skills, Capabilities, and Experiences :

Knowledge of NAIC & CMS COB guidelines strongly preferred.

Excellent oral and written communication skills, PC skills, database system, and related software (word processing, spreadsheets, etc.) strongly preferred.

For candidates working in person or remotely in the below locations, the salary range for this specific position is $19.04 to $34.27

Locations : California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company.

The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting.

This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.

Even within the range, the actual compensation will vary depending on the above factors as well as market / business considerations.

No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans.

The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.

Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates.

Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week.

Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19.

If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

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Last updated : 2024-05-02