Our Mission: Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.
Inspire health in Arizona as the trusted leader in delivering affordable, innovative healthcare solutions.
Our Benefits: Our benefits provide work-life balance and the flexibility you need to be your best. We offer comprehensive medical, dental, and vision coverage; a 401K savings plan; paid holidays and vacations; and much more!
Position Purpose: The Coordination of Benefits Coordinator provides support to the Health Choice Contact Center by ensuring that coordination of benefits is accurate for all Health Choice lines of business by verifying and maintaining primary insurance coverage information.
- Adhere to HIPAA laws at all times; notify Privacy Officer immediately upon learning of a real or potential breach of protected health information.
- Prioritize work flow to maintain an efficient process of completing the assignments daily
- Verifies potential primary insurance via telephone, various on-line portals and/or documents verification
- Interface with outside agencies to report eligibility updates and corrections as necessary (CMS, PMMIS, AHCCCS, HMS and PBM)
- Update primary insurance information within Med/MC - pend members files with later determined primary coverage benefits to claims and recoveries for review
- Maintain COB Mailbox (Processing incoming inquiries from other departments, respond to inquiries from State agencies, Urgent Rx’s, etc.)
- Work daily pended claims report (B3 pends, EZ pends)
- Work various weekly/monthly reports (COB Coverage Type Codes Report, MSP, AZ 834 Report, Pharmacy, etc.)
- Assist with expedited COB Contact Center Chats
- Serve as back-up phone coverage for the Contact Center in adherence to department benchmarks and performance measures.
Education / Experience / Other Requirements
- High School Diploma or equivalent GED preferred
Years of Experience:
- At least one (1) year customer service preferred
- At least one (1) year in call center environment preferred
- At least two (1-2) years’ experience in the health care industry or the AHCCCS program.
- Active listening skills, highly empathetic, conflict resolution skills
- Excellent verbal and written communication skills
- Proficient computer skills, typing, and multi-systems navigation
- Advanced Knowledge of Microsoft Office: Word, Excel
- Effective time management, organizational, and communication skills
- Knowledge of Medicaid and Medicare coverage and regulations and guidelines preferred
- Knowledge of Coordination of Benefits hierarchy
- Knowledge of AHCCCS guidelines
Job Status: Full Time
Job Reference #: R883