This position supports the Medicaid Coordination of Benefits team, ensuring the accuracy of other primary insurance carrier information and supporting the functions of the coordination of benefits team. Supporting multiple health plans. The COB Representative under general supervision, verifies COB, makes changes to member records, updates CVS and addresses a variety of COB questions or concerns. Maintains member’s other insurance coverage in system.
Responds, research, and resolves COB claims related issues involving member specific information; Works directly with Health Plans and/or local claim operations to achieve positive service outcomes. (*) Monitors daily status reports assessing output for developing trends potentially impacting service levels. Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing COB information for accuracy and completeness; partnering with appropriate internal/external support areas when needed Enters all requirements related to the systems processes impacting the generation. When necessary, reviews and corrects transaction errors impacting eligibility interfaces. Determines and communicates standard service charges to internal/external customers related to COB activities; Partners with other team to coordinate the release of COB information.

Pay Range
The typical pay range for this role is:
Minimum: 17.00
Maximum: 27.90

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

• Communicating for Impact
• Collaborating for Results
• Working Across Boundaries
• Microsoft Office suite
• Attention to detail and accuracy
• Problem solving skills
• Strong organization skills

Preferred Qualifications
2-3 years claims processing experience preferred

Education
High School diploma, G.E.D. or equivalent experience

Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.