COB Specialist
Job Summary
To support the Payment Integrity team, the remote COB Specialist will investigate and verify proper payment of medical and pharmacy claims, create and enhance COB workflows, and drive COB audits.
Key responsibilities:
- Contribute as a subject matter expert for COB reimbursement policies and respond to inquiries regarding these policies
- Analyze data to identify dual coverage and develop quantitative analyses of payment issues
- Collaborate with internal and external partners to scope and prioritize COB solutions based on insights from claims reviews
Required qualifications:
- A bachelor's degree or 4+ years of relevant experience
- 4+ years of experience in payment integrity, particularly in coordination of benefits
- Experience with reimbursement methodologies and claims processing practices
- 2+ years of experience deriving business insights from datasets
- 1+ years of experience improving business workflows and collaborating with stakeholders
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