COB Specialist

UPMC • Pittsburgh, PA

1d

About The Position

Join our team as a COB Specialist, where you'll ensure members' coverage is accurate and claims are processed correctly. In this role, you'll investigate other insurance coverage, update member records, and apply state and federal regulations to determine proper coordination of benefits. You'll also partner closely with internal teams and communicate with members, insurers, and external agencies to gather information and resolve issues. This is a full-time position working Monday through Friday daylight hours. Candidates must be located in/near Pennsylvania.

Requirements

• Strong attention to detail
• Analytical skills
• Ability to interpret complex regulations
• Excellent communication skills
• Customer service skills
• High school diploma or equivalent
• 1 year of customer service experience and/or other business environment
• Ability to interpret and apply complex regulations as mandated by CMS, DPW, and PID as related to coordination of benefits, subrogation, and Medicare
• Strong organizational skills
• Strong interpersonal skills
• Leadership skills
• Customer orientation
• Ability to manage multiple tasks and projects
• MS Office/PC skills
• Must be located in/near Pennsylvania

Nice To Haves

• Experience in claims processing, COB, or insurance
• College degree

Responsibilities

• Research and verify other insurance coverage across all lines of business
• Apply CMS, DPW, PID, and Medicare regulations to determine order of benefits
• Update and maintain accurate COB data in internal and external systems
• Resolve claims impacted by other insurance quickly and accurately
• Communicate with members, other insurance carriers, and internal teams to resolve inquiries
• Meet established quality, accuracy, and productivity standards
• Identify trends, issues, and improvement opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees