eCOB Specialist III

Location:
  • VA-NORFOLK, 5800 NORTHAMPTON BLVD, United States of America
  • CA-RANCHO CORDOVA, 11070 WHITE ROCK RD,
  • CA-SACRAMENTO, 1121 L ST,STE 500
  • CT-ROCKY HILL, 500 ENTERPRISE DR
  • CT-WALLINGFORD, 108 LEIGUS RD
  • DE-WILMINGTON, 123 S JUSTISON ST, STE 200
  • FL-ALTAMONTE SPRINGS, 370-774 NORTHLAKE BLVD
  • FL-JACKSONVILLE, 7406 FULLERTON ST, STE 340
  • FL-TAMPA, 5411 SKY CENTER DR
  • GA-ATLANTA, 740 W PEACHTREE ST NW
  • GA-COLUMBUS, 6087 TECHNOLOGY PKWY
  • IA-W DES MOINES, 4800 WESTOWN PKWY, STE200
  • IN-INDIANAPOLIS, 220 VIRGINIA AVE
  • KY-LOUISVILLE, 13550 TRITON PARK BLVD
  • ME-SOUTH PORTLAND, 2 GANNETT DR
  • MN-MENDOTA HEIGHTS, 1285 NORTHLAND DR
  • MO-ST LOUIS, 1831 CHESTNUT ST
  • NC-CARY, 11000 WESTON PKWY, STE 200
  • NC-WINSTON-SALEM, 5650 UNIVERSITY PKWY
  • NH-MANCHESTER, 1155 ELM ST, STE 100 & 200
  • NY-ALBANY, 41 STATE ST
  • NY-LATHAM, 15 PLAZA DR
  • OH-CINCINNATI, 3075 VANDERCAR WAY
  • OH-COLUMBUS, 10 W BROAD ST
  • OH-COLUMBUS, 8940 LYRA DR, STE 300
  • OH-MASON, 4361 IRWIN SIMPSON RD
  • OH-NORWOOD, 4803 MONTGOMERY RD, STE 100
  • OH-SEVEN HILLS, 6000 LOMBARDO CENTER, STE 200
  • TN-BRENTWOOD, 105 WESTWOOD PL, STE 400 (inactive)
  • TN-KNOXVILLE, 9041 EXECUTIVE PARK DR, STE 250
  • TN-NASHVILLE, 22 CENTURY BLVD, STE 310
  • TX-GRAND PRAIRIE, 2505 N HWY 360, STE 300
  • VA-RICHMOND, 2103 STAPLES MILL RD,
  • VA-ROANOKE, 602 S JEFFERSON ST
  • WI-MADISON, 25 W MAIN ST, 5TH FL STE 11
  • WV-CHARLESTON, 200 ASSOCIATION DR, STE 200
Job Reference:
JR117948
Date Posted:
09/05/2024
Anticipated Date Close:
09/10/2024

eCOB Specialist III

Location: Hybrid, within 50 miles of an Elevance Health pulse point.
Hours: Monday - Friday, an 8 hour shift between 6 am - 6 pm

The eCOB Specialist III is 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 a HS diploma or equivalent and a 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.

For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $21.77 to $39.19

Locations: California; New York;

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 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 elevancehealthjobssupport@elevancehealth.com for assistance.