Benefits Specialist

🕒 July 18

🇺🇸 United States – Remote

💵 $40k - $46.2k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👩‍👩‍👧‍👦 Human Resources (HR)

🚫👨‍🎓 No degree required

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Conduent

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

🏥 Healthcare

📦 Logistics

💼 Consulting

💰 Venture Round on 2009-01

Healthcare • Logistics • Consulting

Conduent is a leading provider of technology-led solutions aimed at enhancing customer experiences and improving operational efficiency for businesses and government agencies. The company offers a wide range of services, including customer experience management, finance and accounting solutions, human capital management, integrated digital solutions, and specialized services for healthcare and public sector clients. By leveraging automation and analytics, Conduent helps organizations streamline processes and drive business success.

📋 Description

• Investigate and determine the correct Coordination of Benefits (COB) for members with multiple health insurance plans. • Review insurance eligibility, policy coverage, and documentation to verify the proper payer order. • Contact insurance carriers, Medicare (CMS), employer groups, healthcare providers, and members by phone, email, fax, and mail to validate coverage information. • Research complex healthcare eligibility issues and apply Medicare CMS and NAIC guidelines to determine primary and secondary coverage. • Document findings accurately in company systems while maintaining complete and detailed records. • Review Explanation of Benefits (EOBs) and other insurance documentation to support payment determinations. • Process incoming COB correspondence and update eligibility records as needed. • Handle inbound and outbound calls related to Coordination of Benefits inquiries. • Meet established productivity, quality, and turnaround time goals. • Maintain HIPAA compliance and adhere to all federal, state, and client requirements. • Collaborate with teammates while working independently in a remote environment. • Identify opportunities to improve processes, documentation, and communication.

🎯 Requirements

• Minimum of 2 years of healthcare experience involving Coordination of Benefits (COB) in a provider, payer, or healthcare vendor environment OR 4+ years of experience in insurance verification, medical billing, healthcare claims processing, claims auditing, medical reimbursement, or healthcare data analysis • Working knowledge of Coordination of Benefits (COB) guidelines • Knowledge of Medicare (CMS) regulations and NAIC Coordination of Benefits guidelines • Understanding of medical terminology and healthcare eligibility processes • Strong investigative, research, and critical thinking skills • Excellent verbal and written communication skills • Ability to explain complex insurance information clearly and professionally • Strong customer service skills with the ability to communicate confidently with insurance carriers, providers, employer groups, and members • Experience working in a production-driven environment while maintaining high-quality standards • Strong organizational and multitasking abilities • Proficiency with Microsoft Office (Word, Excel, and Outlook) • Ability to work independently while collaborating effectively with a remote team • Must reside in a state or municipality where the compensation structure complies with applicable wage regulations • Not currently hiring in AK, CA, CT, HI, MA, IL, MT, NY, Minneapolis, Chicago, New York City, Portland, Montgomery County, Seattle, or Washington, DC

🏖️ Benefits

• Fully remote position • Flexible Monday-Friday schedule • No weekends required • Competitive starting pay • Collaborative team environment • Eligible for benefits day 1 • Health insurance coverage • Voluntary dental and vision programs • Life and disability insurance • Retirement savings plan • Paid holidays • Paid time off (PTO) or vacation and/or sick time • Potential bonus or incentive based on business need