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The Coordination of Benefits Associate will research and verify insurance coverage for clients, ensuring compliance with regulations. Our Client is one of the leading Health Plans in the US providing services in multiple states. NTT Business Process Outsourcing (BPO) team offers end-to-end administrative services help streamline operations, improve productivity, and strengthen cash flow to help our customers stay competitive and improve member satisfaction.
Job Responsibility:
Use multiple sources in researching the potential of dual coverage and determining which Insurance is primary
Update Claims System according to Member insurance
Making outbound call to other Insurance companies to verify coverages
Take up additional training/ new assignments or projects that may come up as per client needs
Meet/ exceed required performance measures such as quality and productivity standards
Meet/ exceed process SLAs
Successfully complete the required regulatory and compliance requirements such as the HIPAA
Successfully complete all organizational and client training requirements
Understand how work impacts results for their area as well as other processes
Demonstrate knowledge of internal operations and develops relationships to facilitate workflow
Knowledge of related regulations and standards
Strong understanding of current processes and procedures and may identify opportunities for improvement
Requirements:
High school Diploma or equivalent
3+ years of medical claims or eligibility experience
5+ years of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, leverage internet search engines, and other web-based applications
5+ years of experience with the Microsoft Office suite that required daily usage of Outlook, Excel and Word