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Independence Blue Cross · 13 hours ago

COB Analyst

Philadelphia, PA

Full-time

Onsite

Mid Level

3+ years exp

Independence Blue Cross is focused on enhancing their Coordination of Benefits team to improve claims processing efficiency. The COB Analyst role involves analyzing member coverage to establish primacy, recovering claims, and ensuring accurate information is maintained while collaborating with various internal and external stakeholders.

Health CareHealth InsuranceInsuranceMedical

Responsibilities

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

Qualification

Coordination of Benefits rulesHealth insurance experienceMicrosoft Office proficiencyMulti-tasking abilityCommunication skillsTime managementTeam collaboration