eCOB Specialist II, III - Newborn Benefits
Core
Investigating and coordinating benefits across multiple platforms to determine primacy, reconcile claims, and assist members with Medicare enrollment.
Role type
Claims coordination specialist (COB)
Builds
Accurate claim adjudication and member enrollment status for health insurance groups
Domain
Health insurance / Claims administration
Deliverable
client delivery
Required skills
COB rules interpretation, Medicare enrollment assistance, claim reconciliation, primacy determination, multi-platform investigation
Preferred skills
Newborn benefits experience, WGS experience
Technologies
Internal queries, internal resource tools, digital tools and platforms
Responsibilities
Initiate calls to carriers and providers to identify other coverage; determine primacy using State and Federal laws; update membership systems with investigation results; review claim history for reconciliation; apply COB formulas to adjudicate impacted claims
Seniority
Individual Contributor, mid-level (2-3 years experience)