| Coordinator of Benefits Specialist Job Description |
 |
| The following is a full job description for Coordinator of Benefits Specialist. Here are the requirements and responsibilities for Coordinator of Benefits Specialist along with statistics. If after reading this page you determine that Coordinator of Benefits Specialist is not the position you are looking for, you may want to try one of these similar titles: Benefits Analyst IV, Benefits Supervisor, Benefits Manager, Benefits Senior Manager, Benefits Analyst III, Compensation and Benefits Manager, Benefits Clerk II, Benefits Clerk III, Benefits Administrator II |
|
| Requirements and Responsibilities For Coordinator of Benefits Specialist |
| Determines the correct order of payment liability when members are covered under multiple insurance plans to ensure claims are paid accurately and in compliance with regulatory and contractual guidelines. Investigates and verifies other insurance coverage by reviewing member records, contacting carriers, employers, and members, and updating coordination of benefits (COB) information in the claims system. Applies primary, secondary, and tertiary payer rules in accordance with regulations and plan provisions to adjudicate or adjust claims appropriately. Identifies and recovers overpayments resulting from duplicate or out-of-order payments and initiates refund requests or claim adjustments. Resolves COB-related discrepancies and inquiries from members, providers, and internal departments, documenting findings and outcomes in accordance with established procedures. May require a bachelor's degree. Typically reports to a manager. Occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. Typically requires 2-4 years of related experience. |
| |
|
| Also referred to as: Benefit Validation Coordinator, Benefits Coordinator - Healthcare, Coordination of Benefits Representative (COB), Patient Benefits/Coverage Coordinator |
|
| Similar Jobs: Benefits Analyst IV, Benefits Supervisor, Benefits Manager, Benefits Senior Manager, Benefits Analyst III, Compensation and Benefits Manager, Benefits Clerk II, Benefits Clerk III, Benefits Administrator II |
|
| Level of Education: Coordinator of Benefits Specialist Salaries with No Diploma, Coordinator of Benefits Specialist Salaries with a High School Diploma or Technical Certificate, Coordinator of Benefits Specialist Salaries with an Associate's Degree, Coordinator of Benefits Specialist Salaries with a Bachelor's Degree, Coordinator of Benefits Specialist Salaries with a Master's Degree or MBA, Coordinator of Benefits Specialist Salaries with a JD, MD, PhD or Equivalent |
|
|
| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
