Coordination of Benefits Representative

Job Summary

Working remotely on a full-time basis, the Coordination of Benefits Representative will review patient accounts and claims to identify and validate insurance coverage, resolve COB-related denials, and ensure timely reimbursement across various payers.

Key responsibilities

• Review and validate patient accounts for primary, secondary, and tertiary insurance coverage in compliance with COB rules
• Resolve COB-related denials and coordinate rebilling activities, including submitting corrected claims and ensuring proper documentation
• Communicate with insurance carriers and conduct patient outreach to gather necessary information and resolve inquiries

Required qualifications

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