Job ID: BH495029
Category: Benefits Administrator, Administrative Assistant
Client Job Title: COB/TPL Coordinator
- High School Diploma/GED
- HIPPA Compliant
- Strong Time Management/Organizational Skills
- Proficient with Microsoft Office Suite Programs (i.e. Word, Excel, Outlook, etc.)
- Familiarity with Coordination of Benefits/Third Party Liability
- Knowledge of QNXT Claim Payment System
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.
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.
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.
- Knowledge of QNXT Claim Payment System
- Familiarity with Coordination of Benefits and Third Party Liability
- 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.
- COB/TPL Representatives, Team Leads and Manager
- Finance Representatives
- Service Operations Management and Representatives
The Planet Group of Companies is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.