Driscoll Children's Hospital
Where compassion meets innovation and technology and our employees are family.
Thank you for your interest in joining our team! Please review the job information below.
GENERAL PURPOSE OF JOB
Coordination of Benefits (COB) is the process of determining which of two or more insurance companies will have the primary responsibility of payment and the extent to which the other policies will contribute to the overall payment. The Claims COB Analyst performs claims analysis, research and validation, and associated responsibilities in support of the correct handling of claims involving other insurance coverage. The position additionally serves as a subject matter expert regarding COB related policies and procedures.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Analyze members with other insurance coverage to determine the correct order of benefits. Audit claims to identify services paid as primary in error. Analyze COB claims to determine the correct claim payment. Research and validate other insurance coverage with insurance carriers. Support vendor oversight of COB recovery-related activities. Coach/mentor team members regarding opportunities for identification of COB. Effectively prioritize and complete all assigned tasks within appropriate timeframes and with the required level of quality. Participate openly in team meetings, providing ideas and suggestions to ensure departmental efficiency and quality, and promote teamwork. Maintain required compliance with privacy and confidentiality standards. Maintain or exceed all established standards for performance, quality, and timeliness. Support the Claims department in reviewing, investigating, and researching claims issues. Demonstrate business practices and personal actions that are ethical and adhere to all Health System and Health Plan policies and procedures. Assist with other related work responsibilities as requested. EDUCATION AND/OR EXPERIENCE
- Any combination of education and experience that would likely provide the required knowledge, skills, and abilities is qualifying.
Minimum three years professional experience in claims analysis, provider medical billing, or medical coding; experience with Texas Medicaid preferred. Minimum two years professional experience with Coordination of Benefits, including order of benefit determination and payment calculation; experience with Texas Medicaid preferred Minimum High school graduate or GED required.
Thank you for your interest in joining our team! Please review the job information below.
GENERAL PURPOSE OF JOB
Coordination of Benefits (COB) is the process of determining which of two or more insurance companies will have the primary responsibility of payment and the extent to which the other policies will contribute to the overall payment. The Claims COB Analyst performs claims analysis, research and validation, and associated responsibilities in support of the correct handling of claims involving other insurance coverage. The position additionally serves as a subject matter expert regarding COB related policies and procedures.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Analyze members with other insurance coverage to determine the correct order of benefits. Audit claims to identify services paid as primary in error. Analyze COB claims to determine the correct claim payment. Research and validate other insurance coverage with insurance carriers. Support vendor oversight of COB recovery-related activities. Coach/mentor team members regarding opportunities for identification of COB. Effectively prioritize and complete all assigned tasks within appropriate timeframes and with the required level of quality. Participate openly in team meetings, providing ideas and suggestions to ensure departmental efficiency and quality, and promote teamwork. Maintain required compliance with privacy and confidentiality standards. Maintain or exceed all established standards for performance, quality, and timeliness. Support the Claims department in reviewing, investigating, and researching claims issues. Demonstrate business practices and personal actions that are ethical and adhere to all Health System and Health Plan policies and procedures. Assist with other related work responsibilities as requested. EDUCATION AND/OR EXPERIENCE
- Any combination of education and experience that would likely provide the required knowledge, skills, and abilities is qualifying.
Minimum three years professional experience in claims analysis, provider medical billing, or medical coding; experience with Texas Medicaid preferred. Minimum two years professional experience with Coordination of Benefits, including order of benefit determination and payment calculation; experience with Texas Medicaid preferred Minimum High school graduate or GED required.