eCOB Specialist 2
No salary listed
Junior
Indianapolis, IN, USA+9 moreMore locations: Louisville, KY, USA | Tampa, FL, USA | Miami, FL, USA | Durham, NC, USA | Winston-Salem, NC, USA | St. Louis, MO, USA | Lake Mary, FL, USA | Columbus, GA, USA | Atlanta, GA, USA
RemotePrimarily virtual, with required in-person training, occasional office work, and possible overtime or schedule flexibility.
InsuranceClaims Adjudication
Company Historically Provides H1B Sponsorship
About the job
Requirements
- Requires a high school diploma or equivalent and at least 2 years of claims processing and customer service experience, plus 2 years of coordination of benefits experience using National Association of Insurance Commissioners and Centers for Medicare & Medicaid Services coordination of benefits guidelines; an equivalent combination of education and experience is acceptable.
- Must be able to maintain focus while sitting for extended periods and handle multiple tasks in a fast-paced, high-pressure environment.
- Must have strong verbal and written communication skills for virtual and in-person interactions.
- Must be attentive to detail, think critically, and solve problems.
- Must demonstrate empathy and persistence in resolving caller issues completely.
- Must be comfortable and proficient with digital tools and platforms to enhance productivity and minimize manual effort.
- Must be able to work a structured schedule, with occasional overtime or flexibility based on business needs, and work from the office when necessary.
- Candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and influenza unless they provide an acceptable explanation; requirements follow applicable federal, state, and local laws.
Responsibilities
- Research and investigate other coverage for company groups and members across multiple platforms, performing complex functions and interpreting complex rules, laws, and contracts.
- Manage end-to-end coordination of benefits functionality, including reconciliation of claims, membership, and accounting.
- Use internal queries and resource tools and initiate phone calls to other carriers, members, groups, providers, attorneys, the Centers for Medicare & Medicaid Services, and Medicaid to identify members who are or should be enrolled in other coverage.
- Assist members in enrolling in Medicare when they are entitled to it.
- Determine primacy for each case using complex primacy rules mandated by state and federal laws, including Centers for Medicare & Medicaid Services primacy and National Association of Insurance Commissioners rules, and compare these rules with member and group benefits.
- Update all membership system components with investigation results for claim coordination.
- Ensure the correct forms are provided to assist members with Medicare enrollment.
- Review claim history to identify claims requiring reconciliation, including claims processed, pended, or recovered in error.
- Identify the correct formulas to adjudicate impacted claims, using multiple coordination of benefits formulas for different product types in accordance with state and federal guidelines.
- Handle calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers.
- Perform other duties as assigned.
Desired Qualifications
- Strong organizational and time-management skills.
About the company
Elevance Health is one of the largest U.S. health insurers, covering people through employers, individual plans, Medicare and Medicaid. It is the Blue Cross Blue Shield licensee in 14 states, where it sells plans under the Anthem name, and it runs government plans under the Wellpoint name in other markets. Its Carelon division runs the CarelonRx pharmacy benefit manager and sells behavioral health, care management and other services to its own plans and outside clients. Elevance earns most of its revenue from premiums paid by employers, members and government programs, plus fees for Carelon services. The company is headquartered in Indianapolis, Indiana.
Company Size
10,001+
Company Stage
IPO
Headquarters
Indianapolis, Indiana
Founded
1944
Get referred to Elevance Health
See people who can refer or advise you
Simplify's Take
What believers are saying
- Equity has room to recover: in July 2026 Elevance raised its outlook to at least $27 adjusted earnings per share.
- ACA plans are a growth engine: Elevance had about 1 million marketplace members by June 2026, beating its 900,000 outlook.
- Leaders target a rebound: in July 2026 management set a goal of at least 12% earnings growth for 2027.
What critics are saying
- Medicaid exits cost jobs: Elevance filed notice in September 2026 to cut 216 Louisiana staff, after 85 in D.C.
- Medicaid loses money: Elevance expects a 1.75% operating loss there in 2026 and plans more state exits.
- Regulators flagged data shortcuts in February 2026: Elevance sent Medicare diagnosis fixes on USB drives, a $935 million liability.
What makes Elevance Health unique
- Elevance owns the Blue brand in 14 states: it is the Anthem Blue Cross licensee from California to New York.
- Elevance keeps drug spending in-house: its CarelonRx pharmacy benefit manager handles prescriptions for its own plan members.
- Carelon sells care beyond insurance: Carelon Services revenue rose 7.2% to $8.0 billion in the quarter ending June 2026.
Help us improve and share your feedback! Did you find this helpful?
Benefits
- Medical, dental, & vision insurance
- 401(k) + match
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Stock purchase plan
- Life insurance
- Wellness Programs
- Financial education resources
- Adoption & Surrogacy Assistance
- Dependent-care Flexible Spending Account (DCFSA)
- Parental Leave