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Elevance Health · 11 hours ago

eCOB Specialist II

Indianapolis, IN

Full-time

Hybrid

Mid Level

4+ years exp

Elevance Health is a health company dedicated to improving lives and communities. The eCOB Specialist II is responsible for researching and investigating coverage for members, performing complex functions related to Coordination of Benefits, and ensuring accurate claim processing.

Health CareHealth InsurancePersonal HealthWellness

H1B Sponsor Likely

Responsibilities

Utilizes internal queries, internal resource tools, must initiate delicate-in-nature phone calls to other carriers, members, groups, providers, attorneys, CMS and Medicaid and report to identify members who are or should be enrolled in other coverage

Aides members in enrolling in Medicare when they are entitled

Determines primacy on each case using a complex set of Primacy Rules as mandated by State and Federal Laws, such as CMS Primacy and NAIC rules and comparing them against the member/groups benefits

Updates all of the company's membership system components with investigation results for claim coordination

Ensures correct forms are provided to assist members enrolling in Medicare

Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well as recovered in error

Associate must identify the correct formulas in order to adjudicates impacted claims, using multiple COB Formulas for the various product types, pursuant to State and Federal Guidelines

Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers

Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts

Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary

Performs other duties as assigned

Qualification

COB experienceNAIC guidelinesCMS guidelinesMedicare knowledgeClaims processingCustomer serviceEmpathyDigital tools proficiencyVerbal communicationWritten communicationCritical thinkingProblem-solvingAttention to detail

Required

Requires a HS diploma or equivalent

Minimum of 2 years of claims processing and customer service

2 years COB experience that required using NAIC & CMS COB guidelines

Ability to multi-task, including handling calls, texts, facsimiles, and electronic queues

Strong verbal and written communication skills, both with virtual and in-person interactions

Attentive to details, critical thinker, and a problem-solver

Demonstrates empathy and persistence to resolve caller issues completely

Comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts

Preferred

Medicare and CAQH knowledge preferred

Benefits

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical

Dental

Vision

Short and long term disability benefits

401(k) +match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Company

Elevance Health

Glassdoor3.6

Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.

Founded in 1944

Indianapolis, Indiana, USA

10001+ employees

https://www.elevancehealth.com

H1B Sponsorship

Elevance Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (488)

2024 (604)

2023 (660)

2022 (222)