Anthem, Inc. Hiring for eCOB Specialist I, II, III at Chicago Full Time

Description

SHIFT: Day Job

SCHEDULE: Full-time

eCOB Specialist I, II, III – Job Family This role may be filled as an eCOB Specialist I, II or III level. The hiring manager will determine the level, based on the candidate/s experience and background.

This role is a remote work at home opportunity open nationwide to candidates located within 120 miles of an Anthem location.

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Build the Possibilities. Make an extraordinary impact.

How you will make an impact: As an eCOB Specialist, you are responsible for researching and investigating other coverage for all of the company’s groups and members on multiple platforms. Fully proficient in all key areas, you will perform multi complex functions and interpret complex rules, laws and contracts. You will be accountable for end-to-end functionality on every Coordination of Benefits(COB) function including reconciliation of claim, membership and accounting. Primary duties may include, but are not limited to:

• Utilizing internal queries, internal resource tools, must initiate delicate-in-nature phone calls to other carriers, members, groups, providers, attorneys, CMS and Medicaid and report to identify members who are or should be enrolled in other coverage.

• Aids members in enrolling in Medicare when they are entitled.

• Updates all of the company’s membership system components with investigation results for claim coordination.

• Ensures correct forms are provided to assist members enrolling in Medicare.

• Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well as recovered in error.

• Associate must identify the correct formulas in order to adjudicates impacted claims, using multiple COB Formulas for the various product types, pursuant to State and Federal Guidelines.

Level II duties include the above and:

• Determines primacy on each case using a complex set of Primacy Rules as mandated by State and Federal Laws, such as CMS Primacy and NAIC rules and comparing them against the member/groups Anthem Benefits.

Level III duties include the above level I and II duties as well as:

• Handles complex case research and resolution.

• May assist with training of new associates.

Qualifications

Minimum Requirements eCOB Specialist I requires:

• a HS diploma or equivalent and

• a minimum of 1 year of claims processing and/or customer service and

• a minimum of 1 year coordination of benefits experience;

• or any combination of education and experience which would provide an equivalent background.

eCOB Specialist II requires:

• a HS diploma or equivalent and

• a minimum of 2 years of claims processing and customer service and

• 2 years COB experience that required using NAIC & CMS COB guidelines;

• or any combination of education and experience which would provide an equivalent experience.

eCOB Specialist III requires:

• a HS diploma or equivalent and

• a minimum of 3 years of claims processing and customer service and

• 3 years COB experience that required using NAIC & CMS COB guidelines;

• or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences: For Level I:

• Knowledge of NAIC & CMS COB guidelines strongly preferred. (This knowledge required at levels II and III.)

All 3 Levels:

• Excellent oral and written communication skills

• PC skills, database system, and related software (word processing, spreadsheets, etc.) strongly preferred.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.

Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.

Applicable to Colorado Applicants Only

Hourly Pay Range*: eCOB Specialist I: $17.73/hr – $22.16/hr; eCOB Specialist II: $18.58/hr – $23.22/hr; eCOB Specialist III: $20.27/hr – $25.34/hr

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

• The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

  REQNUMBER: PS72230