COB Analyst
Coordination of Benefits team will work to identifying primacy for our members so claims will pay correctly the first time they are processed. This increased focus will improve our results and continue to keep us on the path to becoming the best performing Blue plan.
The COB Analyst role will work to analyze member’s other coverage to determine primacy and to recover claims paid when other liability is determined. They will follow up with the member, vendor, group, Medicare, or other parties to clarify all required information and update the member file. They will research recovered claims payments and requests adjustments to claims. We are looking for team members who have demonstrated strong analytical skills, consistently high productivity and quality performance, strong written and verbal communication skills and strive to enhance the customer experience in our dynamic and ever-changing environment.
Responsibilities Include:
• Resolves common and complex coordination of benefits and other party liability issues in a timely and accurate manner.
• Works and communicates well (verbal and written) with members, vendors, groups, CMS and other parties to clarify the correct order of benefits.
• Partners with all areas of the company including sales, enrollment, customer service and IT to obtain or provide timely coordination of benefits information.
• Work with Marketing/Sales to validate group’s primacy preferences and requests supporting documentation.
• Research Coordination of Benefits related claims to validate recovered payments and request adjustments when necessary.
• Maintains acceptable productivity and quality performance standards.
• Takes ownership of resolving any issues from start to completion.
• Research and correct CMS submission errors and fallout to ensure primacy is set correctly and coverage changes are submitted to CMS on a timely basis and in accordance to the departments quality and compliance standards.
• Trouble-shoot and identify system issues; highlight potential solutions to Management and document findings.
• Identifies, fixes and eliminates any “coordination of benefits” issues that are identified as inaccurate or incomplete.
• Supports projects of varying degrees of complexity and testing enhancements to system and applications as assigned by Supervisor.
• Collects information related to issues and provides recommendations for educational material for members and providers.
• Responsible for understanding all aspects of the business unit including workflows, processes, related systems and work procedures.
• Keeps knowledgeable on current primacy/coordination of benefits rules.
• Works very well in a team environment.
Skills Required/Qualifications:
• High School Diploma or GED with minimum 3+ years’ experience within the health insurance industry. Bachelor’s degree preferred.
• Strong written and verbal communication skills.
• Ability to interact effectively with all levels of IBC associates and external customers.
• Ability to organize time effectively to meet responsive turnaround times on customer issues is required.
• An understanding of Coordination of Benefits rules.
• Strong and consistent productivity and quality performer.
• Demonstrated ability to work in a multi-taking environment.
• Must have a good understanding of the IBC business environment and associated systems.
• Proficiency with Microsoft Office products.
• Performs other duties as assigned.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.