Job Description

Job Description

The Coordination of Benefit (COB) Specialist is responsible for determining order of benefits when there are 2 or more healthcare policies. This Specialist must be knowledgeable in functions and workflows including working knowledge of Enrollment, Subrogation, Medicare, NAIC guidelines and Claim process procedures. This will include handling correspondence, work in a team environment, and ensure guideline compliance. Able to meet daily and weekly deadlines, effectively communicate with all departments throughout the organization.

JOB RESPONSIBILITIES:

• Phone calls to other Insurance companies, members, providers and Medicare
• Contact CMS to coordinate benefits when required and track ESRD and ALS cases within the Fund
• Process COB correspondence via mail and faxes
• Update and send Claims for reprocessing when COB determinations are made
• Assist/Support the Enrollment Department workflows
• Update and maintain internal procedures manual
• Provide Coordination of Benefit explanations and interpretations with expertise and within Federal regulations

Company Description

National Employee Beneft Fund

Company Description

National Employee Beneft Fund