[Hiring] Benefits Coordinator @Conduent

Role Description

Are you experienced as a Benefits Coordinator, Medicare, insurance verification, healthcare claims, or medical billing? We're looking for a detail-oriented healthcare professional who enjoys solving complex insurance coverage issues and working in a fast-paced remote environment.

As a Benefits Coordinator, you'll:

• Investigate insurance coverage and determine the correct order of benefits.
• Communicate with insurance carriers and healthcare providers.
• Ensure claims are processed accurately while remaining compliant with Medicare and federal regulations.

Key Responsibilities

• Investigate and determine the correct benefits 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.

Qualifications

• Must have a high school diploma or GED.
• Must be able to successfully pass a pre-employment criminal background check and drug screening.
• 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 one or more of the following:
  • Insurance Verification
  • Medical Billing
  • Healthcare Claims Processing
  • Claims Auditing
  • Medical Reimbursement
  • 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.
• Proficiency with Microsoft Office (Word, Excel, and Outlook).
• Ability to work independently while collaborating effectively with a remote team.

Requirements

• Must pass an internet speed test (download equal to or greater than 25, upload equal to or greater than 5, Ping ms equal to or less than 175).
• Must have the ability to connect with an ethernet cable to a modem/router.
• Live in one of the following states: AL, AR, AZ, CO, CT, DE, FL, GA, ID, IN, IA, KS, KY, LA, ME, MI, MS, MO, NE, NV, NH, NJ, NM, NC, OH, OK, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY.
• We are currently NOT hiring in the following geographies, included but not limited to:
  • States: AK, CA, CT, HI, MA, IL, MT & NY.
  • Metro Areas: MN – Minneapolis, IL – Chicago, NY – New York City, OR - Portland, MD - Montgomery County, WA - Seattle, Washington, DC.

Benefits

• Fully remote position.
• Flexible Monday-Friday schedule.
• No weekends required.
• Competitive starting pay.
• Collaborative team environment.
• Eligible for benefits day 1.