Accurately process Coordination of Benefits (COB) claims according to COB policy provisions as stated in plan documents, state/federal regulations and current policies and procedures. Provide COB customer service. Assess current status of COB information and update COB records when new or corrected information is obtained through correspondence and/or personal contact with members, providers, other carriers and internal staff.
Work Experience: One year of PacificSource work experience or equivalent work experience in a related health field.
Education, Certificates, Licenses: High school diploma or equivalent required.
Knowledge: Ability to read and understand health contracts, insurance terminology, benefit language, Explanation of Benefits documentation, COB rules and medical claim forms. Recognizes and understands medical CPT and ICD coding, medical terminology and standard billing practices. Computer skills required, including keyboarding and 10-key proficiency, basic Microsoft Word and Excel. Ability to work under time constraints and quickly understand and apply new information received by phone, correspondence and email. Team player willing to collaborate and help others accomplish team objectives. Medical terminology ICD-9 / CPT coding needed. Prior coordination of benefits and customer call center experience helpful.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.