Coordination of Benefits Specialist

Coordination of Benefits Specialist

Pay: Starting at $20.00/hour (based on experience), which may be below your state's minimum wage. Please take this into consideration when applying.

Schedule: Monday-Friday | 9:00 AM - 5:30 PM EST 

Location: Fully Remote

About this role:

Are you experienced in Coordination of Benefits (COB), Medicare, insurance verification, healthcare claims, or medical billing? We're looking for a detail-oriented healthcare professional who enjoys solving complex insurance coverage issues and working in a fast-paced remote environment.

As a Coordination of Benefits (COB) Specialist, you'll investigate insurance coverage, determine the correct order of benefits, communicate with insurance carriers and healthcare providers, and ensure claims are processed accurately while remaining compliant with Medicare and federal regulations.

If you have strong analytical skills, enjoy researching insurance eligibility, and take pride in delivering accurate, high-quality work, we'd love to hear from you.

Key Responsibilities:

• Investigate and determine the correct Coordination of Benefits (COB) for members with multiple health insurance plans.
• Review insurance eligibility, policy coverage, and documentation to verify the proper payer order.
• Contact insurance carriers, Medicare (CMS), employer groups, healthcare providers, and members by phone, email, fax, and mail to validate coverage information.
• Research complex healthcare eligibility issues and apply Medicare CMS and NAIC guidelines to determine primary and secondary coverage.
• Document findings accurately in company systems while maintaining complete and detailed records.
• Review Explanation of Benefits (EOBs) and other insurance documentation to support payment determinations.
• Process incoming COB correspondence and updating eligibility records as needed.
• Handle inbound and outbound calls related to Coordination of Benefits inquiries.
• Meet established productivity, quality, and turnaround time goals.
• Maintain HIPAA compliance and adhere to all federal, state, and client requirements.
• Collaborate with teammates while working independently in a remote environment.
• Identify opportunities to improve processes, documentation, and communication.

Required Qualifications:

• Minimum of 2 years of healthcare experience involving Coordination of Benefits (COB) in a provider, payer, or healthcare vendor environment

OR

• 4+ years of experience in one or more of the following:
  • Insurance Verification
  • Medical Billing
  • Healthcare Claims Processing
  • Claims Auditing
  • Medical Reimbursement
  • Healthcare Data Analysis
• Working knowledge of Coordination of Benefits (COB) guidelines.
• Knowledge of Medicare (CMS) regulations and NAIC Coordination of Benefits guidelines.
• Understanding of medical terminology and healthcare eligibility processes.
• Strong investigative, research, and critical thinking skills.
• Excellent verbal and written communication skills.
• Ability to explain complex insurance information clearly and professionally.
• Strong customer service skills with the ability to communicate confidently with insurance carriers, providers, employer groups, and members.
• Experience working in a production-driven environment while maintaining high-quality standards.
• Strong organizational and multitasking abilities.
• Proficiency with Microsoft Office (Word, Excel, and Outlook).
• Ability to work independently while collaborating effectively with a remote team.

Why You'll Love This Opportunity

• Fully remote position
• Flexible Monday-Friday schedule
• No weekends required
• Competitive starting pay
• Collaborative team environment
• Eligible for benefits day 1

If you're an experienced healthcare professional with a background in Coordination of Benefits, insurance verification, medical billing, or healthcare claims, we'd love to hear from you. Apply today!

 Due to varying state and local minimum wage laws, we are currently only able to hire candidates residing in states where our compensation structure complies with applicable wage regulations. As a result, we may be unable to consider applicants from certain states or municipalities at this time.

We are currently NOT hiring in the following geographies, included but not limited to: 
States: AK, CA, CT, HI, MA, IL, MT & NY 
Metro Areas: MN – Minneapolis, IL – Chicago, NY – New York City, OR - Portland, MD - Montgomery County, WA - Seattle, Washington, DC

Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information.  For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $39,960-$46,200.