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Conduent
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Vakances uzņēmumā

Remote Benefits Coordinator - Coordination of Benefits

Conduent is seeking a remote Benefits Coordinator to investigate healthcare eligibility and Coordination of Benefits matters for U.S. members. The role verifies coverage, applies Medicare and NAIC guidance, and supports accurate claims and payment decisions.

USAmerikas Savienotās ValstisALAlabamaAZArizonaCOKolorādoCTKonektikutaFLFloridaIDAidahoIAAiovaKSKanzasaKYKentukiLALuiziānaMEMeinaMIMičiganaMSMisisipiMOMisūriNENebraskaNVNevadaNHŅūhempšīraNJŅūdžersijaNMŅūmeksikaNCZiemeļkarolīnaOHOhaioOKOklahomaPAPensilvānijaRIRodailendaSCDienvidkarolīnaSDDienviddakotaTNTenesīTXTeksasaUTJūtaVTVērmontaVAVirdžīnijaWAVašingtonaWVRietumvirdžīnijaWIViskonsinaWYVaiominga
39 960 $ – 46 200 $ / gads
AttālinātiPilna slodzeJaunākais speciālistsVidējais līmenisGrāds nav nepieciešamsNepieciešamā Valoda: angļuPabalstu koordinatorsVispārīgi

Apraksts

  • Determine appropriate benefits for members covered by multiple health plans.
  • Examine eligibility, policy coverage, and supporting documents to establish the correct payer sequence.
  • Verify coverage details with insurers, Medicare (CMS), employer groups, healthcare providers, and members through phone, email, fax, and mail.
  • Investigate complex eligibility cases and use Medicare CMS and NAIC guidance to identify primary and secondary coverage.
  • Record conclusions precisely in company systems and maintain thorough documentation.
  • Evaluate Explanation of Benefits (EOB) statements and related insurance records to inform payment decisions.
  • Process incoming Coordination of Benefits correspondence and make necessary eligibility record updates.
  • Manage inbound and outbound calls concerning Coordination of Benefits questions.
  • Achieve defined productivity, quality, and turnaround-time targets.
  • Protect HIPAA compliance and follow applicable federal, state, and client requirements.
  • Work independently in a remote setting while coordinating effectively with teammates.
  • Recommend improvements to processes, documentation, and communication.

Prasības

  • High school diploma or GED.
  • Successful completion of a pre-employment criminal background check and drug screening.
  • At least 2 years of healthcare experience involving Coordination of Benefits (COB) in a provider, payer, or healthcare vendor setting, or more than 4 years in insurance verification, medical billing, healthcare claims processing, claims auditing, medical reimbursement, or healthcare data analysis.
  • Working knowledge of Coordination of Benefits (COB) guidelines.
  • Knowledge of Medicare (CMS) regulations and NAIC Coordination of Benefits guidelines.
  • Understanding of medical terminology and healthcare eligibility procedures.
  • Strong investigative, research, and critical-thinking abilities.
  • Excellent verbal and written communication skills.
  • Ability to explain complex insurance information clearly and professionally.
  • Strong customer service skills and confidence communicating with insurers, providers, employer groups, and members.
  • Proficiency with Microsoft Office, including Word, Excel, and Outlook.
  • Ability to work independently and collaborate effectively with a remote team.
  • Internet speed test results of at least 25 Mbps download, 5 Mbps upload, and 175 ms ping or lower.
  • Ability to connect to a modem or router using an ethernet cable.
  • Residence in one of the listed eligible U.S. states.

Priekšrocības

  • Fully remote work arrangement.
  • Flexible Monday-to-Friday schedule.
  • No weekend work required.
  • Competitive starting pay.
  • Collaborative team environment.
  • Benefits eligibility beginning on day one.
  • Health insurance coverage.
  • Voluntary dental and vision programs.
  • Life and disability insurance.
  • Retirement savings plan.
  • Paid holidays.
  • Paid time off (PTO) or vacation and/or sick time.
  • Bonus or incentive eligibility based on business needs.

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