COB Specialist

Medical Mutual of Ohio

421d

About The Position

The COB Specialist position at Medical Mutual involves researching and responding to inquiries regarding health insurance coverages for members and their dependents. The role requires coordination with various stakeholders to gather necessary data, resolve issues, and maintain accurate member files. The position is available at two levels: COB Specialist I and Sr. COB Specialist, each with specific responsibilities and qualifications.

Requirements

• Bachelors' Degree in Business or Healthcare Administration or related field preferred, but will consider collective experience, training, and education.
• 3 years of relevant experience in health insurance or the health care industry for COB Specialist I.
• 1 year experience as a COB Specialist or equivalent 3 years experience in health insurance claims or customer service operations for Sr. COB Specialist.
• Knowledge of health insurance products and services, benefits.
• Intermediate Microsoft Office and document workflow management systems skills for COB Specialist I.
• Knowledge of NAIC and ODI Rules of Order, ASO requirements, COBRA, Medicare, and Medicaid rules for Sr. COB Specialist.
• Strong knowledge of COB concepts and company policies related to COB administration for Sr. COB Specialist.

Nice To Haves

• Certified Professional Coder (preferred)

Responsibilities

• Researches and responds to inquiries/issues regarding health insurance coverages for members and dependents.
• Contacts membership, providers, and other insurance companies to gather coordination of benefits (COB) data.
• Determines source of problems, impact to customers, and resolution.
• Generates reports in various systems to access daily inventory.
• Identifies and determines appropriate conditions to apply.
• Researches, resolves, and responds to moderately complex and time-sensitive inquiries using both internal and external systems.
• Reviews and approves appropriate payment orders for customer service inquiries routed to the COB department for investigation and file update.
• Maintains member COB files from returned correspondence/questionnaires.
• Participates in departmental meetings and assists in the development of workflow and process improvements.
• Answers phone inquiries regarding COB from internal customers such as customer service, operations, and other insurance companies.
• Performs other duties as assigned.

Benefits

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance.
• Access to an Employee Assistance Program.
• Company holidays and up to 16 PTO days during the first year of employment.
• Parental leave for eligible employees after 120 days of service.
• Career development programs and classes.
• Mentoring and coaching to help advance in your career.
• Tuition reimbursement up to $5,250 per year.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees