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eCOB Specialist III

  • Job Family: Claims
  • Type: Full time
  • Date Posted:
  • Req #: JR37207

Location:

  • NJ, Morristown
  • Texas, Austin
  • Georgia, Midland
  • Ohio, Youngstown
  • Colorado, Denver
  • Arkansas, Little Rock
  • Texas, Texas
  • Louisiana, Baton Rouge
  • New Jersey, Iselin
  • Ohio, Seven Hills
  • Georgia, Columbus
  • California, Woodland Hills
  • Ohio, Mason
  • California, Walnut Creek
  • Georgia, Augusta
  • Georgia, Atlanta
  • Kentucky, Louisville
  • Ohio, Columbus
  • Tennessee, Nashville
  • Ohio, Cincinnati
  • Florida, Tampa
  • Ohio, Ohio
  • Arkansas, Arkansas
  • Kansas, Topeka
  • North Carolina, Winston
  • New Hampshire, Manchester
  • New Hampshire, New Hampshire
  • Iowa, West Des Moines
  • Nevada, Las Vegas
  • Tennessee, Knoxville
  • Nevada, Nevada
  • Nebraska, Omaha
  • Nebraska, Lincoln
  • Nebraska, Nebraska
  • Virginia, Chesapeake
  • Wisconsin, Waukesha
  • California, Rancho Cordova
  • North Carolina, Cary
  • North Carolina, Cary
  • Wisconsin, Pewaukee
  • Missouri, St. Louis
  • North Carolina, North Carolina
  • Florida, Miami Lakes
  • Florida, Miami
  • California, Palo Alto
  • Wisconsin, Wisconsin
  • Missouri, Columbia
  • West Virginia, Charleston
  • Virginia, Ashburn
  • Virginia, Arlington
  • West Virginia, West Virginia
  • Florida, Jacksonville
  • Virginia, Alexandria
  • Iowa, Iowa
  • Washington, Seattle
  • Minnesota, Mendota Heights
  • Minnesota, Gilbert
  • New York, Middletown
  • Minnesota, Minnesota
  • Michigan, Wixom
  • Washington, Lakewood
  • Tennessee, Tennessee
  • New York, Latham
  • Washington, Bellevue
  • Washington, Washington
  • California, Glendale
  • South Carolina, Columbia
  • Indiana, Indianapolis
  • Michigan, Dearborn
  • Michigan, Michigan
  • Rhode Island, Smithfield
  • Massachusetts, Woburn
  • Florida, Florida
  • California, Costa Mesa
  • District of Columbia, Washington
  • District of Columbia, District of Columbia
  • Delaware, Wilmington
  • New York, New York
  • California, Cerritos
  • Delaware, Delaware
  • Indiana, Indiana
  • Illinois, Springfield
  • Massachusetts, Boston
  • Connecticut, Wallingford
  • Massachusetts, Andover
  • Virginia, Roanoke
  • Massachusetts, Massachusetts
  • Texas, Houston
  • Virginia, Richmond
  • Connecticut, Rocky Hill
  • Illinois, Deerfield
  • Texas, Grand Prairie
  • Illinois, Chicago
  • Illinois, Illinois
  • Hawaii, Kapolei
  • Maryland, Hanover
  • Pennsylvania, Hermitage
  • Pennsylvania, Pennsylvania
  • Virginia, Norfolk
  • Georgia, Savannah
  • New Jersey, Morristown
  • Maine, Maine

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Description

Build the Possibilities. Make an extraordinary impact.

As a eCOB III Specialist you will be responsible for researching and investigating other coverage for all of the company's groups and member 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 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. 
  • Handles complex case research and resolution. May assist with training of new associates.

Minimum Requirements:

  • Requires an HS diploma or equivalent
  • Minimum of 3 years of claims processing and customer service and 3 years COB experience that required using NAIC & CMS COB guidelines; or
  • Any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • Experience with Medicare ESRD
  • Self-Starter/ Self-Motivator

Hourly Pay Range*: $18.24/hr - $30.41 /hr (Min – MRP)

Locations:  Colorado; Nevada, Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY

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 from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 ability@icareerhelp.com for assistance.

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