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Coordination of Benefits Specialist I

Company: BlueCross and BlueShield of Massachusetts
Location: Quincy
Posted on: May 17, 2022

Job Description:

Ready to help us transform healthcare? Bring your true colors to blue.

This Coordination of Benefits position is responsible for investigating and determining primacy according to Federal and State regulations for members with more than one health coverage (Medical and/or Dental). Respond to members, providers and customer service inquiries pertaining to coordination of benefits by researching and resolving all related inventory. Maintain the internal Coordination of Benefits files up to date.

Key Responsibilities

* Learn and maintain a working knowledge of all Federal and State regulations that govern the determination of primacy
* Investigate and coordinate benefits when more than one insurance exists
* Establish, update and maintain the Coordination of Benefits files by researching and investigating all sources for information
* Adjust claims according to the information on file
* Support internal areas with inquiries related to Coordination of Benefits
* Support the Coordination of Benefits Call Center
* Work with Members, Providers, Other Payers, Medicare Intermediaries and Accounts to gather the details surrounding each case for resolution.
* Consistently achieve quality and productivity standards.


* Basic computer skills
* Ability to work independently, in addition to working in a team environment
* Must be organized and have the ability to prioritize multiple assignments
* Excellent communication skills

Education/Relevant Experience

* High School diploma or equivalent required
* Minimum of one year business experience
* Customer service experience prefer
* Coordination of Benefits experience a plus
* Claim processing experience a plus

This position is eligible for E-working, Resident & Mobile

Minimum Education Requirements:

High school degree or equivalent required unless otherwise noted above



Time Type

Full time

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. We provide a flexible hybrid work model in which roles are designated as resident (on site 4-5 days/week), mobile (on site 1-3 days/week), or eworker (on site 0-3 days/month).

Blue Cross Blue Shield of Massachusetts, has a COVID-19 vaccination requirement for building entry. Your offer of employment is dependent upon either being fully vaccinated for COVID-19 or an accommodation based on a disability or sincerely held religious belief, practice, or observance by submitting a request to Human Resources.

Keywords: BlueCross and BlueShield of Massachusetts, Quincy , Coordination of Benefits Specialist I, Other , Quincy, Massachusetts

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