Cobalt Benefits Group, LLC (DBA: Blue Benefit Administrators, CBA Blue & EBPA)

Claims Specialist

• Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims.
• Review, apply and create refund letters for all lines of business to members and providers.
• Reprocess payments when necessary.
• Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions.
• Review plan documents for various groups to research and resolve claim processing questions and issues.
• Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request.
• Perform other related duties, as assigned.

Healthcare Claims Specialist

• Ensure accuracy of claims adjudication while maintaining quality and turn around goals.
• Adjudicate medical, dental and vision claims.
• Review plan documents for various groups to apply appropriate benefits to claims being adjudicated.
• Prioritize assigned claims by adjudicating oldest claims first.
• Communicate effectively with internal auditors and management team.
• Perform other related duties, as assigned.

Health Benefits Claims Examiner

Designer

• Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions.
• Read and interpret benefits to build out the benefit plans by coding, building, revising, and maintaining self-insured healthcare plans in the claims adjudication system.
• Ensure that both the plan documents and the plans within the system are aligned with regulatory standards and client specifications.
• Collaborate with internal implementation teams, account managers, and other stakeholders to ensure the accurate setup of new plans and updates to existing plans.
• Troubleshoot and resolve plan build issues or errors in the claims adjudication system to ensure proper claim processing.
• Conduct ongoing research on evolving healthcare regulations and adjust documents and plan builds accordingly.
• Provide guidance to junior staff and internal teams on the proper application of plan design principles and system builds.

Senior Plan Design Review – Builder, Self-Funded Healthcare Plans

Customer Support

• Provide administrative support to the sales team, including managing schedules, preparing proposals, and handling correspondence.
• Coordinate and process sales orders, ensuring accuracy and timely fulfillment.
• Communicate with clients and partners to confirm offer details, answer inquiries, and provide updates on delivery or product availability.
• Maintain and update Salesforce with customer information, sales activities, and pipeline data.
• Generate reports for sales metrics, forecasts, and customer trends.
• Collaborate with marketing, logistics, and finance teams to support cross-functional initiatives.
• Assist with preparing materials for sales presentations.
• Support with the completion and tracking of RFP’s.

Healthcare Claims Specialist

Health Benefits Claims Examiner

Senior Plan Design Review – Builder, Self-Funded Healthcare Plans

Sales Support Specialist