Coordination of Benefits Representative

Job Summary

Working remotely in a full-time capacity, the Coordination of Benefits Representative will review patient accounts and claims to identify and validate insurance coverage, resolve COB-related denials, and coordinate rebilling activities across various payer types to ensure timely reimbursement.

Key responsibilities

• Review patient accounts to identify primary, secondary, and tertiary insurance coverage in accordance with COB rules
• Validate insurance information in billing systems and resolve COB-related denials through appropriate follow-up actions
• Communicate with insurance carriers and government agencies to verify coverage and educate internal staff on COB requirements

Required qualifications

• High School Diploma or GED required
• Knowledge of Medicare, Medicaid, commercial insurance, and COB/MSP rules
• Familiarity with hospital billing systems, such as Epic Resolute HB/PB
• Ability to interpret EOBs and remittance advice
• Demonstrated comfort with regular patient contact, including outreach and follow-up