eCOB Specialist II – Newborn Benefits

Elevance Health

. Research and investigate other coverage for company groups and members on multiple platforms .

Posted 10/12/2026full-timeUnited StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Coordination of Benefits functions, including claims processing and reconciliation, while effectively assisting members with Medicare enrollment. Proficient in applying NAIC and CMS guidelines to determine primacy and manage multiple tasks in a fast-paced environment.

Highest-signal resume keywords

Claims ProcessingCoordination Of Benefits (COB)NAIC GuidelinesCMS GuidelinesCustomer Service

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ReconciliationMembership System UpdatesMedicare Enrollment AssistanceCOB FormulasInvestigation Techniques

Soft Skills

Organizational SkillsTime ManagementEmpathyPersistenceCommunication

Industry Keywords

MedicaidNewborn BenefitsWGS ExperienceState And Federal LawsClaim History Review

About the role

Key responsibilities & impact

Research and investigate other coverage for company groups and members on multiple platforms
Perform end-to-end Coordination of Benefits functions, including claim, membership, and accounting reconciliation
Use internal queries and resource tools to identify members who are or should be enrolled in other coverage
Make phone calls to carriers, members, groups, providers, attorneys, CMS, and Medicaid
Assist members with enrolling in Medicare when entitled
Determine primacy using CMS Primacy, NAIC rules, State and Federal laws, and member/group benefits
Update membership system components with investigation results for claim coordination
Ensure correct forms are provided for Medicare enrollment
Review claim history to identify claims requiring reconciliation or recovery correction
Identify formulas and adjudicate impacted claims using COB formulas for various product types
Handle calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers
Maintain focus during extended sitting and manage multiple tasks in a fast-paced, high-pressure environment
Resolve caller issues completely with empathy and persistence
Work a structured schedule with occasional overtime or flexibility based on business needs
Perform other duties as assigned

Requirements

What you’ll need

HS diploma or equivalent
Minimum of 2 years of claims processing and customer service
2 years COB experience requiring use of NAIC & CMS COB guidelines
Any combination of education and experience which would provide an equivalent experience
Newborn benefits experience strongly preferred
WGS experience strongly preferred
Strong organizational and time management skills preferred
Ability to work within a reasonable commuting distance from the posting location(s), unless accommodation is granted as required by law
Ability to work from the office as necessary
Ability to become vaccinated against COVID-19 and Influenza for certain patient/member-facing roles, unless an acceptable explanation is provided