Benefits Coordinator

This is a fully remote position, open to applicants in Alabama, +34 more states.

📋 Description

• Investigate and identify the appropriate benefits for members enrolled in multiple health insurance plans.

• Assess insurance eligibility, policy coverage, and documentation to ensure correct payer order.

• Communicate with insurance carriers, Medicare (CMS), employer groups, healthcare providers, and members via phone, email, fax, and mail.

• Research complex healthcare eligibility matters and apply Medicare CMS and NAIC guidelines to ascertain primary and secondary coverage.

• Accurately document findings within company systems and maintain comprehensive, detailed records.

• Review Explanation of Benefits (EOBs) and other insurance documents to support payment decisions.

• Process incoming Coordination of Benefits correspondence and update eligibility records accordingly.

• Manage both inbound and outbound calls related to Coordination of Benefits inquiries.

• Achieve established productivity, quality, and turnaround-time targets.

• Uphold HIPAA compliance and adhere to federal, state, and client regulations.

• Collaborate with team members while working autonomously in a remote setting.

• Identify and propose opportunities to enhance processes, documentation, and communication.

⛳️ Requirements

• High school diploma or GED is required.

• Successful completion of a pre-employment criminal background check and drug screening is mandatory.

• A minimum of 2 years of healthcare experience in Coordination of Benefits (COB) within a provider, payer, or healthcare vendor setting, OR over 4 years of experience in Insurance Verification, Medical Billing, Healthcare Claims Processing, Claims Auditing, Medical Reimbursement, or Healthcare Data Analysis.

• Proficient understanding of Coordination of Benefits (COB) guidelines.

• Familiarity with Medicare (CMS) regulations and NAIC Coordination of Benefits guidelines.

• Knowledge of medical terminology and healthcare eligibility processes.

• Strong investigative, research, and critical thinking abilities.

• Exceptional verbal and written communication skills.

• Capability to articulate complex insurance information clearly and professionally.

• Excellent customer service skills with insurance carriers, providers, employer groups, and members.

• Proficient in Microsoft Office (Word, Excel, and Outlook).

• Ability to work independently while effectively collaborating with a remote team.

• Must pass an internet speed test: download speed ≥25 Mbps, upload speed ≥5 Mbps, ping ≤175 ms.

• Must connect to a modem/router via an ethernet cable.

• Must reside in one of the eligible states listed.

• Must adhere to applicable work-location and wage-regulation restrictions.

🏝️ Benefits

• Fully remote position.

• Flexible schedule from Monday to Friday.

• No weekend work required.

• Competitive starting salary.

• Collaborative team-oriented environment.

• Eligible for benefits from day one.

• Health insurance coverage.

• Voluntary dental and vision insurance options.

• Life and disability insurance coverage.

• Retirement savings plan.

• Paid holidays.

• Paid time off (PTO) or vacation and/or sick leave.

• Potential bonus or incentive based on business needs.