Benefits Coordinator

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

📋 Description

• Examine and ascertain the appropriate benefits for members enrolled in multiple health insurance plans.

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

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

• Investigate complex healthcare eligibility concerns and implement Medicare CMS and NAIC guidelines to establish primary and secondary coverage.

• Accurately document findings in company systems while keeping comprehensive and precise records.

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

• Manage incoming Coordination of Benefits (COB) correspondence and update eligibility records accordingly.

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

• Achieve predefined productivity, quality, and turnaround time objectives.

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

• Work collaboratively with team members while independently navigating a remote work environment.

• Recognize opportunities to enhance processes, documentation, and communication.

⛳️ Requirements

• High school diploma or GED is required.

• Must successfully pass a pre-employment criminal background check and drug screening.

• At least 2 years of experience in healthcare with Coordination of Benefits (COB) in a provider, payer, or healthcare vendor setting OR a minimum of 4 years in insurance verification, medical billing, healthcare claims processing, claims auditing, medical reimbursement, or healthcare data analysis.

• Familiarity with Coordination of Benefits (COB) guidelines is essential.

• Knowledge of Medicare (CMS) regulations and NAIC Coordination of Benefits guidelines is required.

• Understanding of medical terminology and healthcare eligibility processes is necessary.

• Strong investigative, research, and critical thinking abilities.

• Outstanding verbal and written communication skills.

• Capability to explain intricate insurance information clearly and professionally.

• Excellent customer service skills, with the ability to confidently interact with insurance carriers, providers, employer groups, and members.

• Proficiency 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 ≥25 Mbps, upload ≥5 Mbps, ping ≤175 ms.

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

• Residency in one of the eligible listed U.S. states is required.

🏝️ Benefits

• Fully remote position.

• Flexible schedule from Monday to Friday.

• No weekend work required.

• Competitive starting salary.

• Collaborative team atmosphere.

• Eligibility for benefits from day one.

• Health insurance coverage included.

• Optional dental and vision plans available.

• Life and disability insurance provided.

• Retirement savings plan offered.

• Paid holidays.

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

• Potential for bonuses or incentives based on business needs.