COB Coordinator
On-siteCoral Gables, Florida, United States
Job Summary
Analyze, process, research, and adjudicate claims involving other insurance carriers while monitoring COB claims according to CMS guidelines. Investigate members for secondary coverage via phone calls and correspondence, manage questionnaires and letters to members and providers, and ensure timely processing of all COB claims. Enter claims or verify data entry for accuracy, maintain quality standards in research and adjustment functions, and act as a liaison to providers and members for special claims handling. Comply with HIPAA, OSHA, and federal regulations while communicating effectively with staff to achieve positive customer outcomes. Requires bilingual English/Spanish proficiency and 1–3 years of health claims processing experience.
Required Qualifications
- Excellent oral and written communication skills
- 1 – 3 years of Health claims processing experience
- Working knowledge of COB and MSP
- Working knowledge of medical terminology
- Working knowledge of current Medicare Advantage operational and regulatory guidelines established by CMS, AHCA and other federal and state regulatory guidelines
- Excellent organizational skills
- Ability to work well under pressure in difficult situations
- Bilingual: English / Spanish
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