About this role
Conduent is seeking a detail-oriented Coordination of Benefits (COB) Specialist to work remotely from the United States. This role focuses on investigating and coordinating insurance coverage, determining the correct order of benefits, and ensuring accurate claim processing in compliance with Medicare and federal regulations. The position offers a fully remote work arrangement, a Monday–Friday schedule from 9:00 AM to 5:30 PM EST, and starting pay of $20.00 per hour, based on experience.
Responsibilities
- Investigate and determine the correct Coordination of Benefits for members with multiple health insurance plans.
- Review insurance eligibility, policy coverage, and documentation to verify the proper payer order.
- Contact insurance carriers, Medicare (CMS), employer groups, healthcare providers, and members by phone, email, fax, and mail to validate coverage information.
- Research complex healthcare eligibility issues and apply Medicare CMS and NAIC guidelines to determine primary and secondary coverage.
- Document findings accurately in company systems and maintain complete and detailed records.
- Review Explanation of Benefits (EOBs) and other insurance documentation to support payment determinations.
- Process incoming COB correspondence and update eligibility records as needed.
- Handle inbound and outbound calls related to COB inquiries.
- Meet established productivity, quality, and turnaround time goals.
- Maintain HIPAA compliance and adhere to all federal, state, and client requirements.
- Collaborate with teammates while working independently in a remote environment.
- Identify opportunities to improve processes, documentation, and communication.
Requirements
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A minimum of 2 years of healthcare experience involving Coordination of Benefits (COB) in a provider, payer, or healthcare vendor environment
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OR 4+ years of experience in one or more of the following areas: Insurance Verification, Medical Billing, Healthcare Claims Processing, Claims Auditing, Medical Reimbursement, Healthcare Data Analysis, with working knowledge of COB guidelines
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Knowledge of Medicare (CMS) regulations and NAIC COB guidelines
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Understanding of medical terminology and healthcare eligibility processes
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Strong investigative, research, and critical thinking skills
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Excellent verbal and written communication skills, with the ability to explain complex insurance information clearly and professionally
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Strong customer service skills and confidence in communicating with insurance carriers, providers, employer groups, and members
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Experience in a production-driven environment while maintaining high-quality standards
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Strong organizational and multitasking abilities
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Proficiency with Microsoft Office (Word, Excel, Outlook)
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Ability to work independently while collaborating effectively with a remote team
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Notes
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This position may be limited by state wage regulations, and some candidates may be ineligible due to geographic restrictions.
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The employer reserves the right to adjust compensation based on location, experience, and performance. Benefits information and additional details are provided separately by Conduent.