Healthcare Coordination of Benefits Analyst

Job Description: • Review assigned pre-pay or post-pay records, investigate coverage, and determine primacy to maximize revenue for client’s recovery programs. • Review eligibility and other documentation to verify current payer order of benefits. • Leverage knowledge and expertise in COB/TPL to review eligibility. • Identify trends from payer data to process appropriately per client and business needs. • Contact Healthcare Insurance carriers regarding eligibility discrepancies. • Educate Healthcare Insurance carriers on Coordination of Benefits rules. • Analyze written communication from insurance companies including explanation of benefits (EOBs). • Support internal groups with gathering and interpretation of eligibility work. • Follow standards of quality and productivity metrics assigned by management. Requirements: • High School diploma or GED. • Minimum 2 years of directly relevant progressive experience in Healthcare with a focus including but not limited to claims, billing, membership, enrollment, eligibility, customer service and/or call center demonstrating depth of knowledge and capability required for the position. • 12 months direct experience in COB, TPL, Reclamation and/or Recovery is preferred. Benefits: • medical • dental • vision • HSA/FSA options • life insurance coverage • 401(k) savings plans • family/parental leave • paid holidays • paid time off annually Apply tot his job Apply To this Job