Job Openings

Job ID: BH495029

Category: Benefits Administrator, Administrative Assistant

Specialty: Administrative

Client Job Title: COB/TPL Coordinator

Must Haves:

• High School Diploma/GED
• HIPPA Compliant
• Strong Time Management/Organizational Skills
• Proficient with Microsoft Office Suite Programs (i.e. Word, Excel, Outlook, etc.)

Preferred:

• Familiarity with Coordination of Benefits/Third Party Liability
• Knowledge of QNXT Claim Payment System

Job Summary:

The COB/TPL Coordinator role will be centered around sorting, mailing, distributing, and monitoring of department correspondence, along with data entry, refund processing and member eligibility verifications. This is a high energy position which requires strong organizational skills, the ability to prioritize work and collaborate with multiple teams within the organization.

ESSENTIAL FUNCTIONS:

TPL Coordinator Duties:

• Responsible for printing and mailing all COB and TPL correspondence, including certified mail and certified cards. Approximately 100-150 mail items per day.
• Responsible for updating new/current TPL files in Image Silo.
• Responsible for entering all COB and TPL related refund checks into the refund database in a timely manner and assigning to appropriate staff. Collaborate with Finance and Service Operations to ensure that all refunds are entered and processed correctly.
• Maintain a consistent workflow of correspondence to ensure timely delivery of certified mail and time sensitive material.
• Exceptional awareness of HIPAA regulations to ensure all member PHI is protected while handling high correspondence volume.
• Fax/Scan priority claim call tracking’s to COB/TPL Reps working remotely.
• Monitor/order letterhead, envelopes, certified cards for COB and TPL teams and order supplies as necessary.
• Responsible for monitoring and maintaining the TPL printer and making arrangement for technical support to ensure consistent correspondence production.
• Prepare and send closed TPL files along with file lists for scanning.
• COB Coordinator Duties:
• Responsible for quarterly CMS query file and Medicare eligibility updates.
• Responsible for understanding and applying COB claim attributes to ensure accurate reporting of COB savings each month.
• Responsible for retrieving voice mail messages and following proper department procedures to assist with issues.

COB and TPL Duties:

• Responsible for understanding and accurately assisting with COB/TPL inquiries from internal departments, members, providers, and other health plans.
• Responsible for managing the printing, mailing, and processing of any COB/TPL questionnaires to include entering returned questionnaire information, updated addresses and processing call tracking’s related to questionnaires.
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
• Works closely with COB/TPL team and assist with daily duties as assigned.

DEPARTMENT SPECIFIC/NON-ESSENTIAL FUNCTIONS:

• Other duties as assigned with or without accommodation.

WORKING CONDITIONS AND PHYSICAL EFFORT”

• Work is normally performed in a typical office work environment.

• This is a position that is 100% in office and remote working is not available.

MINIMUM REQUIREMENTS:

KNOWLEDGE AND EDUCATION Required:

• High School diploma or GED is required.
• Strong organizational and time management skills a must.
• EXPERIENCE Required:
• Must be proficient in Microsoft Word, and Excel.
• Proficient PC skills including familiarity with Microsoft Access.
• Preferred/Desired:
• Knowledge of QNXT Claim Payment System
• Familiarity with Coordination of Benefits and Third Party Liability

INCUMBENT/CANDIDATE PROFILE:

SKILLS/COMPETENCIES

• The successful candidate will possess strong organizational and time management skills.
• Customer service skills, excellent communication skills, and be able to multi-task and prioritize. In addition, you must have problem solving skills and be highly organized.
• Must be able to collaborate with COB/TPL team as well as other teams in the organization such as Finance and Service Operations.
• Respects the talent and unique contribution of every individual, culture and ethnic group and treats all people in a fair and equitable manner.
• Exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.
• Accountable for delivering high quality work.
• Ability to work independently when necessary.
• Embody company values of Thoughtfully Courageous, Purposefully Simple, Unconditionally Good, Consciously Inclusive and Responsively Agile.

ORGANIZATIONAL RELATIONSHIPS/SCOPE:

• COB/TPL Representatives, Team Leads and Manager
• Finance Representatives
• Service Operations Management and Representatives