Coordination of Benefits Associate

Responsibilities

• Use multiple sources in researching the potential of dual coverage and determining which insurance is primary.
• Update Claims System according to member insurance.
• Make outbound calls to other insurance companies to verify coverages.
• Take up additional training, new assignments, or projects that may come up as per client needs.
• Meet or exceed required performance measures such as quality and productivity standards.
• Meet or exceed process SLAs.
• Successfully complete the required regulatory and compliance requirements such as HIPAA.
• Successfully complete all organizational and client training requirements.
• Understand how work impacts results for their area as well as other processes.
• Demonstrate knowledge of internal operations and develop relationships to facilitate workflow.
• Possess knowledge of related regulations and standards.
• Have a strong understanding of current processes and procedures and may identify opportunities for improvement.
• Research the Coordination of Benefits (COB) for potential dual coverage by other health insurance companies for all subscribers, spouses, and affected dependents, and determine which insurance is primary. COB research extends to all coverage offered by Health Net.

• High school diploma or equivalent.
• 3+ years of medical claims or eligibility experience.
• 5+ years of experience using a computer with Windows PC applications, including keyboard use, navigation, internet search engines, and other web-based applications.
• 5+ years of experience with the Microsoft Office suite, requiring daily usage of Outlook, Excel, and Word.
• Ability to type 40 words per minute.

Required schedule availability for this position is Monday‑Friday (08:00 am to 08:00 pm CST/EST). The shift timings can be changed as per client requirements. Additionally, resources may have to work overtime and on weekends based on business requirements.