Benefits Specialist

Conduent

Coordination of Benefits Specialist investigating insurance coverage issues for healthcare claims remotely. Collaboration with insurance carriers and healthcare providers in a fast-paced environment.

Posted 7/18/2026full-timeRemote • Alaska, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New York, Washington • 🇺🇸 United StatesJuniorMid-Level💰 $20 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Coordination of Benefits (COB) processes, including insurance verification, medical billing, and healthcare claims processing, while ensuring compliance with Medicare (CMS) and NAIC guidelines. Exhibits strong investigative and communication skills to effectively manage complex healthcare eligibility issues and maintain high-quality standards in a remote work environment.

Highest-signal resume keywords

Coordination Of Benefits (COB)Insurance VerificationMedical BillingHealthcare Claims ProcessingMedicare (CMS) Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Coordination Of Benefits (COB) GuidelinesHealthcare Data AnalysisClaims AuditingMedical ReimbursementMedical TerminologyHealthcare Eligibility Processes

Soft Skills

Investigative SkillsResearch SkillsCritical ThinkingCustomer Service SkillsOrganizational Abilities

Tools & Technologies

Microsoft Office (Word, Excel, Outlook)

Industry Keywords

HIPAA ComplianceExplanation Of Benefits (EOB)Insurance DocumentationPayer OrderProductivity Goals

About the role

Key responsibilities & impact

Investigate and determine the correct Coordination of Benefits (COB) for members with multiple health insurance plans
Review insurance eligibility, policy coverage, and documentation to verify the proper payer order
Contact insurance carriers, Medicare (CMS), employer groups, healthcare providers, and members by phone, email, fax, and mail to validate coverage information
Research complex healthcare eligibility issues and apply Medicare CMS and NAIC guidelines to determine primary and secondary coverage
Document findings accurately in company systems while maintaining complete and detailed records
Review Explanation of Benefits (EOBs) and other insurance documentation to support payment determinations
Process incoming COB correspondence and updating eligibility records as needed
Handle inbound and outbound calls related to Coordination of Benefits inquiries
Meet established productivity, quality, and turnaround time goals
Maintain HIPAA compliance and adhere to all federal, state, and client requirements
Collaborate with teammates while working independently in a remote environment
Identify opportunities to improve processes, documentation, and communication

Requirements

What you’ll need

Minimum of 2 years of healthcare experience involving Coordination of Benefits (COB) in a provider, payer, or healthcare vendor environment
4+ years of experience in one or more of the following:
- Insurance Verification
- Medical Billing
- Healthcare Claims Processing
- Claims Auditing
- Medical Reimbursement
- Healthcare Data Analysis
Working knowledge of Coordination of Benefits (COB) guidelines
Knowledge of Medicare (CMS) regulations and NAIC Coordination of Benefits guidelines
Understanding of medical terminology and healthcare eligibility processes
Strong investigative, research, and critical thinking skills
Excellent verbal and written communication skills
Ability to explain complex insurance information clearly and professionally
Strong customer service skills with the ability to communicate confidently with insurance carriers, providers, employer groups, and members
Experience working in a production-driven environment while maintaining high-quality standards
Strong organizational and multitasking abilities
Proficiency with Microsoft Office (Word, Excel, and Outlook)
Ability to work independently while collaborating effectively with a remote team