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coordination of benefits verification rep.

• dover , delaware (remote)

• posted august 30, 2024

job details

summary

• $19 - $20 per hour

• temp to perm

• high school

• category office and administrative support occupations

• referenceAB_4599654

job details

This position will be responsible for investigating potential recoveries for COB by spearheading the verification of other insurances through phone calls and other systems as required. This position will also be responsible for managing communications with internal and external customers and providing a high level of customer services to all customers. Deals directly with other insurances, providers, members and CMS. Qualifications:

• High School diploma or GED is required.

• Associate's Degree or the equivalent combination of training and experience is preferred.

• Knowledge in working with third party payors.

• 2-4 years of related experience in the COB/TPL or other HealthCare related field.

• Must be proficient in Microsoft Word, Excel and Access

• Knowledge of ICD-9, CPT & HCPC coding or equivalent experience.

salary: $19 - $20 per hour

shift: First

work hours: 8 AM - 5 PM

education: High School

Responsibilities

• Responsible for identifying recovery opportunities within the COB/TPL Department.

• Review and validate other insurance information by contacting other health plans (state and national). Responsible for communicating and documenting this information to internal customers on the COB team

• Responsible for phone calls to or from members, providers, and other insurance companies to gather or provide coordination of benefits data.

• Responsible for reviewing, researching and resolving email inquiries from internal customers regarding member's claims and/or eligibility updates.

• Maintain and update accurate COB information in QNXT for reporting to MassHealth and other customers as needed.

• Process COB questionnaires to members and monitor and document responses. Communicate findings to COB colleagues for follow up.

• Responsible for reviewing projects or reports of members with other insurances. This includes flagging members with COB information.

• Meets monthly quality assurance metrics established by the department.

• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect

Skills

• Medical Billing

• Time Management

• Health Insurance Policies

Qualifications

• Years of experience: 2 years

• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

This posting is open for thirty (30) days.

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SD

samantha dougherty

• sam.dougherty@randstadusa.com