UCare

Coordination of Benefits Specialist

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Dec 16, 2021
Closes
Jan 19, 2022
Ref
2714
Category
Healthcare
Employment Status
Full Time
Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.

Rewards

Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

www.ucare.org/careers/

EOE/AA

ABOUT UCARE

UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.

WORKING AT UCARE

Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 12 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.

PROVIDER CONTRACT COORDINATOR

Work Location: Work from home, in the office or hybrid (in the office 3 or more days per week)

The health and safety of our employees, members, providers, and our community is our highest priority. Therefore, all new employees are expected to be fully vaccinated against COVID-19 prior to starting at UCare, subject to limited exceptions such as for a sincerely held religious belief or for medical reasons.

Position Description

This position is responsible to review and analyze all incoming coordination of benefits including order of benefits determination. Update member and subscriber files with Other Insurance information. Reviews all the necessary data obtained from internal and external sources regarding coordination of benefits.

• Knowledge of COB rules for all products.

• Update Amisys Liability and Recovery sub-system with COB information as obtained through claims, TPL, COBC and Part D, DHS Exception Report, HealthLogix, other insurance letters, enrollment applications and any other resources not specifically listed.

• Identify adjustments based on COB investigation. Refer to Claims Recovery team for recovery of overpayments.

• Meet department standards for production in COB queues. Timely completion of pended service forms and to do list in EXP.

• Verify member secondary insurance; confirm insurance information and particulars with the other carrier as needed.

• Review and respond to correspondence received in the TPL inquiry mailbox.

• Provide timely updates to CMS and DHS regarding other insurance information including new COB occurrences or discrepancies with the data.

• Other duties and projects as assigned.

Education

High school diploma or equivalent.

Required Experience

Must have knowledge of rules established by Medicare and Medicaid for coordination of benefits and rules established by the (NAIC) National Association of Insurance Commissioners for other group insurance.

Preferred Experience

Previous COB investigation experience highly desirable. Prior experience in claims processing with various types of plans in Amisys claims systems. Experience with Medicaid, Medicare and commercial (including self-funded) managed care programs as relating to claims administration and insurance.

THE UCARE DIFFERENCE

The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

JOB POST DATE: 12/15/2021

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