Anthem, Inc. eCOB Specialist I in Mason, Ohio
SHIFT: Day Job
eCOB Specialist I
Location: Indiana, Colorado, Illinois, Maine. New Hampshire, Ohio, Virginia, Georgia, Connecticut,
Applicable to Colorado Applicants Only: Hourly Pay Range: $/15 - $/23
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. 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.
The eCOB Specialist I is responsible for researching and investigating other coverage for all of the company's groups and members. 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.
Primary duties may include, but are not limited to:
• 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. • Aide members in enrolling in Medicare when they are entitled. • Updates all 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 reconcile processed, pended or recovered in any error. • Associate must identify the correct formulas to adjudicate impacted claims, using multiple COB Formulas for the various product types, pursuant to State and Federal Guidelines.
The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against Covid-19. All offers of employment are conditioned on completion of a background check, including COVID-19 vaccination verification. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.
Requires a HS diploma or equivalent and a minimum of 1 year of claims processing and/or customer service and a minimum of 1 year coordination of benefits experience; or any combination of education and experience which would provide an equivalent background.
Knowledge of NAIC & CMS COB guidelines strongly preferred. Excellent oral and written communication skills, PC skills, database system, and related software (word processing, spreadsheets, etc.) strongly preferred.
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. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.