Coordination of Benefits Specialist at Conduent Payment Integrity Solution Inc.
United States
$39.96k - $46.2k
<p class="elementtoproof"><span>Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.</span></p> <style></style><br><p style="line-height: normal; text-align: center;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 18pt;"><strong>Coordination of Benefits Specialist</strong></span></span></p><p style="line-height: normal; text-align: center;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;"><strong>Pay:</strong> Starting at $20.00/hour (based on experience), which may be below your state's minimum wage. Please take this into consideration when applying.</span></span></p><p style="line-height: normal; text-align: center;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;"><strong>Schedule:</strong> Monday-Friday | 9:00 AM - 5:30 PM EST </span></span></p><p style="line-height: normal; text-align: center;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;"><strong>Location:</strong> Fully Remote</span></span></p><p style="line-height: normal;"><span style="font-family: "Times New Roman", serif;"><span style="font-size: 18pt;">About this role:</span></span></p><p style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Are you experienced in Coordination of Benefits (COB), Medicare, insurance verification, healthcare claims, or medical billing? We're looking for a detail-oriented healthcare professional who enjoys solving complex insurance coverage issues and working in a fast-paced remote environment.</span></span></p><p style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">As a Coordination of Benefits (COB) Specialist, you'll investigate insurance coverage, determine the correct order of benefits, communicate with insurance carriers and healthcare providers, and ensure claims are processed accurately while remaining compliant with Medicare and federal regulations.</span></span></p><p style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">If you have strong analytical skills, enjoy researching insurance eligibility, and take pride in delivering accurate, high-quality work, we'd love to hear from you</span></span><span style="font-family: "Times New Roman", serif;">.</span></p><p style="line-height: normal;"><span style="font-family: "Times New Roman", serif;"><span style="font-size: 18pt;">Key Responsibilities:</span></span></p><ul style="list-style-type: disc;"><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Investigate and determine the correct Coordination of Benefits (COB) for members with multiple health insurance plans.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Review insurance eligibility, policy coverage, and documentation to verify the proper payer order.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Contact insurance carriers, Medicare (CMS), employer groups, healthcare providers, and members by phone, email, fax, and mail to validate coverage information.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Research complex healthcare eligibility issues and apply Medicare CMS and NAIC guidelines to determine primary and secondary coverage.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Document findings accurately in company systems while maintaining complete and detailed records.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Review Explanation of Benefits (EOBs) and other insurance documentation to support payment determinations.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Process incoming COB correspondence and updating eligibility records as needed.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Handle inbound and outbound calls related to Coordination of Benefits inquiries.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Meet established productivity, quality, and turnaround time goals.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Maintain HIPAA compliance and adhere to all federal, state, and client requirements.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Collaborate with teammates while working independently in a remote environment.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Identify opportunities to improve processes, documentation, and communication.</span></span></li></ul><p style="line-height: normal;"> </p><p style="line-height: normal;"><span style="font-family: "Times New Roman", serif;"><span style="font-size: 18pt;">Required Qualifications:</span></span></p><ul style="list-style-type: disc;"><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Minimum of 2 years of healthcare experience involving Coordination of Benefits (COB) in a provider, payer, or healthcare vendor environment</span></span></li></ul><p style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;"><strong>OR</strong></span></span></p><ul style="list-style-type: disc;"><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">4+ years of experience in one or more of the following:</span></span><ul style="list-style-type: circle;"><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Insurance Verification</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Medical Billing</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Healthcare Claims Processing</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Claims Auditing</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Medical Reimbursement</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Healthcare Data Analysis</span></span></li></ul></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Working knowledge of Coordination of Benefits (COB) guidelines.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Knowledge of Medicare (CMS) regulations and NAIC Coordination of Benefits guidelines.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Understanding of medical terminology and healthcare eligibility processes.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Strong investigative, research, and critical thinking skills.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Excellent verbal and written communication skills.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Ability to explain complex insurance information clearly and professionally.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Strong customer service skills with the ability to communicate confidently with insurance carriers, providers, employer groups, and members.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Experience working in a production-driven environment while maintaining high-quality standards.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Strong organizational and multitasking abilities.</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Proficiency with Microsoft Office (Word, Excel, and Outlook).</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Ability to work independently while collaborating effectively with a remote team.</span></span></li></ul><p style="line-height: normal;"> </p><p style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;"><strong>Why You'll Love This Opportunity</strong></span></span></p><ul style="list-style-type: disc;"><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Fully remote position</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Flexible Monday-Friday schedule</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">No weekends required</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Competitive starting pay</span></span></li><li style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;">Collaborative team environment</span></span></li><li style="line-height: normal;">Eligible for benefits day 1</li></ul><p> </p><p style="line-height: normal;"><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt;"><strong>If you're an experienced healthcare professional with a background in Coordination of Benefits, insurance verification, medical billing, or healthcare claims, we'd love to hear from you. Apply today!</strong></span></span></p><p style="line-height: normal;"> </p><p><span style="font-family: "Aptos Display", sans-serif;"><span style="font-size: 11pt; line-height: 115%;"> </span><i><span style="font-size: 11pt; line-height: 115%;">Due to varying state and local minimum wage laws, we are currently only able to hire candidates residing in states where our compensation structure complies with applicable wage regulations. As a result, we may be unable to consider applicants from certain states or municipalities at this time.</span></i></span></p><p class="paragraph" style="margin: 0in; vertical-align: baseline;"><span style="font-family: "Arial Nova Light", sans-serif;"><span class="normaltextrun" style="font-size: 11pt;"><strong>We are currently NOT hiring in the following geographies, included but not limited to:</strong></span><span class="scxw50386917" style="font-size: 11pt;"> </span></span><br><span style="font-family: "Arial Nova Light", sans-serif;"><span class="normaltextrun" style="font-size: 11pt;">States: AK, CA, CT, HI, MA, IL, MT & NY</span><span class="scxw50386917" style="font-size: 11pt;"> </span></span><br><span style="font-family: "Arial Nova Light", sans-serif;"><span class="normaltextrun" style="font-size: 11pt;">Metro Areas: MN – Minneapolis, IL – Chicago, NY – New York City, OR - Portland, MD - Montgomery County, WA - Seattle, Washington, DC</span></span></p><p> </p><p>Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $39,960-$46,200.</p><br><p class="elementtoproof">Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.</p> <p class="MsoNormal">For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: <a href="https://downloads.conduent.com/content/usa/en/file/conduent-applicant-adaaa-referral-form.pdf" target="_blank" rel="nofollow">click here to access or download the form</a>. Complete the form and then email it as an attachment to <a href="mailto:FTADAAA@conduent.com" target="_blank" rel="nofollow">FTADAAA@conduent.com</a>. You may also <a href="http://downloads.conduent.com/content/usa/en/document/cdt_adaaa_accommodation_pol.pdf" target="_blank" rel="nofollow">click here to access Conduent's ADAAA Accommodation Policy</a>.</p>
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