Coordination of Benefits
Coordination of Benefits (COB) is a process used by insurance companies to handle situations where a person has multiple insurance plans. It helps determine which insurance company pays first and how much each plan should contribute. This prevents duplicate payments and ensures proper coverage. For example, if someone has insurance through both their employer and their spouse's employer, COB rules determine how these plans work together. This is a crucial function in health insurance companies, as it affects billing, claims processing, and customer service.
Examples in Resumes
Managed Coordination of Benefits processes for a portfolio of 5,000 members
Reduced claim processing time by 40% through improved COB procedures
Trained customer service team on Coordination of Benefits guidelines and best practices
Led department's COB unit, handling complex multiple-coverage scenarios
Typical job title: "Coordination of Benefits Specialists"
Also try searching for:
Where to Find Coordination of Benefits Specialists
Professional Organizations
Job Boards
Professional Networks
Example Interview Questions
Senior Level Questions
Q: How would you handle a complex situation where a member has three different insurance policies?
Expected Answer: A senior specialist should explain the order of benefit determination rules, discuss how to identify primary, secondary, and tertiary coverage, and describe the process of coordinating payments between multiple insurers.
Q: How would you improve a COB department's efficiency?
Expected Answer: Should discuss implementing automated verification systems, streamlining communication between insurers, training staff, and creating clear procedures for handling common scenarios.
Mid Level Questions
Q: What are the main rules for determining primary versus secondary coverage?
Expected Answer: Should explain birthday rule for dependent children, active vs. retired employee coverage, and how employer-provided insurance typically coordinates with Medicare.
Q: How do you handle Medicare coordination with other insurance plans?
Expected Answer: Should demonstrate understanding of Medicare Secondary Payer rules, when Medicare is primary vs. secondary, and how to process claims accordingly.
Junior Level Questions
Q: What is the purpose of Coordination of Benefits?
Expected Answer: Should explain that COB prevents duplicate payments, ensures proper coverage, and determines which insurance pays first when someone has multiple plans.
Q: What information do you need to process a COB claim?
Expected Answer: Should list basic requirements like member information, all active insurance policies, coverage dates, and claim details.
Experience Level Indicators
Junior (0-2 years)
- Basic understanding of insurance terms
- Claims processing
- Customer service
- Data entry accuracy
Mid (2-5 years)
- Complex claims resolution
- Medicare coordination
- Team training
- Process improvement
Senior (5+ years)
- Department management
- Policy development
- Workflow optimization
- Regulatory compliance
Red Flags to Watch For
- Limited knowledge of basic insurance terminology
- No experience with claims processing software
- Poor attention to detail in documentation
- Lack of understanding of Medicare rules
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