Elevance Health • Newton, MA 02458
Job #2683512053
WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.
eCOB Specialist II
Job Family: CLM > Claims Support
Type: Full time
Date Posted:Apr 16, 2024
Anticipated End Date:May 03, 2024
Reference: JR108871
Location:
GA, COLUMBUS
PA, SEVEN FIELDS
VA, ARLINGTON
FL, MIAMI
MA, BOSTON
IN, INDIANAPOLIS
OH, CINCINNATI
VA, RICHMOND
NY, NEW YORK
CT, ROCKY HILL
CA, RANCHO CORDOVA
MI, WIXOM
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
NE, LINCOLN
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
WI, Waukesha
NJ, MORRISTOWN
TN, MEMPHIS
OH, MASON
NY, ALBANY
CA, SACRAMENTO
CA, WALNUT CREEK
PA, HERMITAGE
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
VA, NORFOLK
CA, LOS ANGELES
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
NE, OMAHA
HI, KAPOLEI
GA, AUGUSTA
IA, W DES MOINES
MA, WOBURN
MA, NEWTON 55 CHAPEL ST
Description
eCOB Specialist II
Location: Hybrid, within 50 miles of Elevance Health PulsePoint location.
Hours: Monday-Friday, an 8-hour shift between the hours of 6am-6pm.
An eCOB Specialist II is responsible for researching and investigating other coverage for all of the company's groups and members on multiple platforms. Fully proficient in all key areas; 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.
Determines primacy on each case using a complex set of Primacy Rules as mandated by State and Federal Laws, such as CMS Primacy and NAIC rules and comparing them against the member/group's benefits.
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 identify claims requiring reconciliation, whether processed or pended, as well as recovered in 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.
Minimum Requirements:
Preferred skills, experiences, and capabilities:
CS90/Kernal claim processing experienced preferred.
Previous claims experience preferred.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $19.20 to $34.55
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.
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 ~~~ for assistance.
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Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.
EEO Policy Statement
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Elevance Health, Inc. is anE-verify Employer (~~~)
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