Cob/Tpl Coordinator

Wentworth-Douglass Hospital Somerville , MA 02143

Posted 6 months ago

The COB/TPL Administrative Coordinator role will be centered around sorting, mailing, distributing and monitoring of department correspondence, along with data entry and member eligibility verifications. The candidate will be responsible for either TPL or COB duties as follows. This is a high energy position which requires a strong sense of urgency and prioritization.

Essential Functions:

  • TPL Coordinator Duties:

  • Responsible for printing and mailing all COB and TPL correspondence, including certified mail. Approx 100-150 mail items per day.

  • Responsible for updating new/current TPL files in Image Silo for NEDocs.

  • Responsible for receiving, scanning and tracking all TPL lien settlement checks and sending them to Finance each day.

  • Able to verify TPL 2k and 8k PIP letters for daily mail.

  • Maintain a consistent work flow of correspondence to ensure timely delivery of certified mail and time sensitive material.

  • Exceptional awareness of HIPAA regulations to ensure all member PHI is protected while handling high correspondence volume.

  • Fax/Scan priority claim call trackings to COB/TPL Reps working from home.

  • Monitor/order NHP letterhead, envelopes, certified cards for COB and TPL teams. Print certified cards for TPL Reps when needed.

  • Responsible for monitoring and maintaining the TPL printer and making arrangement for technical support to ensure consistent correspondence production.

  • Prepare and send closed TPL files to NEDocs monthly along with file lists for scanning. COB Coordinator Duties:

  • Responsible for understanding and accurately assisting with COB inquiries from internal departments, members, providers and other health plans.

  • Responsible for monitoring the monthly eligibility files from various vendors and ensuring all member eligibility is updated accurately and timely.

  • Responsible for daily verification using claim edit identification and assigned projects.

  • Responsible for quarterly CMS query file and Medicare eligibility updates.

  • Responsible for making phone inquiries to health plans, members, providers and CMS.

  • Responsible for understanding and applying COB claim attributes to ensure accurate reporting of COB savings each month.

  • Responsible for understanding all claim edits as they relate to COB claim processing and reporting.

  • Responsible for retrieiving voice mail messages and following proper department procedures to assist with issues.

  • Responsible for processing all COB questionnaire received from NHP's Self Funded and Performance Guarantee groups.

  • Works closely with COB team and assist with daily duties as assigned.

  • Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.

  • Hold self and others accountable to meet commitments.

  • Ensure diversity, equity, and inclusion are integrated as a guiding principle.

  • Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.

  • Build strong relationships and infrastructures that designate AllWays Health Partners as a people-first organization. Other duties as assigned with or without accommodation.

Working Conditions:

  • Work is normally performed in a typical office work environment. Required:

  • High School diploma or GED is required.

  • Strong organizational and time management skills a must.

  • Must be proficient in Microsoft Word, and Excel.

  • Proficient PC skills including familiarity with Microsoft Access.


  • Knowledge of Qnxt Claim Payment System

  • Knowledge of Coordination of Benefits/Third Party Liability


  • The successful candidate will possess strong organizational and time management skills.

  • Customer service skills, excellent communication skills, and be able to multi-task and prioritize. In addition, you must have problem solving skills and be highly organized.

  • Demonstrates NHP Core Values of Service Excellence, Quality Care, Diversity, Responsibility and Relationships.

  • Respects the talent and unique contribution of every individual, culture and ethnic group and treats all people in a fair and equitable manner.

  • Exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.

  • Accountable for delivering high quality work.

  • Demonstrate AllWays Health Partners' core brand principles of always listening, challenging conventions, and providing value.

  • Respect the talent and unique contribution of every individual, and treat all people in a fair and equitable manner.

  • Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback.

  • Be accountable for delivering high-quality work. Act with a clear sense of ownership.

  • Bring fresh ideas forward by actively listening to and working with employees and the people we serve.

Certification or Conditions of Employment:

  • Pre-employment background check
  • CORI background check
icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Functional Coordinator

IBM Corporation

Posted 3 days ago

VIEW JOBS 10/18/2019 12:00:00 AM 2020-01-16T00:00 Introduction As a Package Consultant at IBM, get ready to tackle numerous mission-critical company directives. Our team takes on the challenge of designing, developing and re-engineering highly complex application components and integrating software packages using various tools. You will use a mix of consultative skills, business knowledge, and technical expertise to effectively integrate packaged technology into our clients' business environment and achieve business results. Your Role and Responsibilities The Functional consultant will lead SAP application development, and conduct systems analysis or program on various system configurations. This position is based in Picatinny, NJ. Required Technical and Professional Expertise * Experience leading SAP application development efforts. * Demonstrated progressive experience from work as a systems analyst or programmer on various system configurations to leadership advisory roles. * 7+ years SAP ECC 6.0 experience. * Strong Experience with the MM (Purchase Requests, Purchase Orders, Invoice, Receipts, Vendor Master) module. * Experience with interfaces using IDocs. * Three project lifecycle experiences. * Integration knowledge of MM, FIN, SD, PS, IMWM, and SCP modules. Preferred Technical and Professional Expertise * Discrete manufacturing SAP experience preferred. About Business Unit IBM Services is a team of business, strategy and technology consultants that design, build, and run foundational systems and services that is the backbone of the world's economy. IBM Services partners with the world's leading companies in over 170 countries to build smarter businesses by reimagining and reinventing through technology, with its outcome-focused methodologies, industry-leading portfolio and world class research and operations expertise leading to results-driven innovation and enduring excellence. Your Life @ IBM What matters to you when you're looking for your next career challenge? Maybe you want to get involved in work that really changes the world? What about somewhere with incredible and diverse career and development opportunities – where you can truly discover your passion? Are you looking for a culture of openness, collaboration and trust – where everyone has a voice? What about all of these? If so, then IBM could be your next career challenge. Join us, not to do something better, but to attempt things you never thought possible. Impact. Inclusion. Infinite Experiences. Do your best work ever. About IBM IBM's greatest invention is the IBMer. We believe that progress is made through progressive thinking, progressive leadership, progressive policy and progressive action. IBMers believe that the application of intelligence, reason and science can improve business, society and the human condition. Restlessly reinventing since 1911, we are the largest technology and consulting employer in the world, with more than 380,000 IBMers serving clients in 170 countries. Location Statement For additional information about location requirements, please discuss with the recruiter following submission of your application. Being You @ IBM IBM is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. IBM is also committed to compliance with all fair employment practices regarding citizenship and immigration status. Preferred Education: None Commissionable: No Key Job Details * Country:US * State:NEW JERSEY * City:SOMERVILLE * Category:Consultant * Required Education:Bachelor's Degree * Position Type:Professional * Employment Type:Full-Time * Contract Type:Regular * Req ID:274058BR * Location:SOMERVILLE, NJ US IBM Corporation Somerville MA

Cob/Tpl Coordinator

Wentworth-Douglass Hospital