• Job Description

  Req#: 1447326

  You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

  Position Purpose: Using multiple sources, this position researches Coordination of Benefits (COB) for potential dual coverage by other health insurance companies for all subscribers, spouses and affected dependants and determines which insurance is prime. COB research extends to all coverage offered by Health Net.

  • Calls hospitals, insurance companies, medical groups and/or members requesting other insurance information as it pertains to dual coverage, eligibility and termination dates of coverage.
  • Researches various COB information from lead sources including but not limited to Member Enrollment Forms, returned member request letters, prior claims, authorizations and Call Center Contacts.
  • Makes COB determinations in accordance to COB guidelines (NAIC, CMS, DMHC, DOI or other resources).
  • Updates the COB master file with other insurance information.
  • Sends correspondence to members requesting COB information.
  • Identifies need to re-adjudicate claims for members when Health Net (HN) is secondary.
  • Performs other duties as assigned.

  Education/Experience: High school diploma or equivalent required; college degree preferred. One year experience in health insurance industry; prior experience in claims working with coordination of benefits processes preferred and or one year experience in a customer service environment.

  Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

  Pay Range: $18.27 - $31.10 per hour

  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

  Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

• About the company

  Centene Corporation is a publicly traded managed care company based in St.

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