Claims Specialist Lead

The University of Kansas Health System; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

The University of Kansas Health System is seeking a Claims Specialist Lead at the Southlake Campus to support the Claims Manager and staff, managing workload, troubleshooting, and ensuring compliance with government and managed care rules.

This role emphasizes mentoring, identifying trends, submitting claims, and maintaining productivity and quality standards; a High School diploma plus several years of claims experience are required, with Epic experience preferred.

Qualifications

• High School Graduate or GED.
• 3 or more years of experience in claims, or insurance processing.
• Associate's Degree in a related field of study from an accredited college or university.
• 4 or more years of Epic experience.

Responsibilities

• Assists in coordinating the team’s workload.
• Works closely with team members on problem solving, training and mentoring.
• Acts as subject matter expert in absence of the department manager to both internal and external customers.
• Observes and communicates to the Claims manager trends with claims processing by insurance companies or technical issues with the claims clearing house.
• Confirms receipt of daily billing files by the claims clearing house.
• Researches and resolves any claim rejections within designated timeframes.
• Reports any claim rejection trends or delays to management.
• Submits paper claims and supporting documentation as required by payers.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities.
• Skills and duties may vary dependent upon your department or unit.
• Other duties may be assigned as required.

Skills

Claims processing

Team coordination

Education

High School Diploma or GED

Associate's Degree in related field

Tools

Epic software

Job description

Position Title Claims Specialist Lead Days - Full Time Southlake Campus

Position Summary / Career Interest: The Claims Specialist Lead is responsible for assisting the Claims Manager and Claims Staff with claim issues. The positions assist the Claims Manager with workload assignments as needed, filling in for staff as needed, and troubleshooting questions in the absence of the Claims Manager. Complies with governmental and managed care rules and regulations. Meets department goals as well as productivity and quality standards.

Responsibilities and Essential Job Functions

• Assists in coordinating the team’s workload.
• Works closely with team members on problem solving, training and mentoring.
• Acts as subject matter expert in absence of the department manager to both internal and external customers.
• Observes and communicates to the Claims manager trends with claims processing by insurance companies or technical issues with the claims clearing house.
• Confirms receipt of daily billing files by the claims clearing house.
• Researches and resolves any claim rejections within designated timeframes.
• Reports any claim rejection trends or delays to management.
• Submits paper claims and supporting documentation as required by payers.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities.
• Skills and duties may vary dependent upon your department or unit.
• Other duties may be assigned as required.

Required Education and Experience

• High School Graduate or GED.
• 3 or more years of experience in claims, or insurance processing.

Preferred Education and Experience

• Associate's Degree in a related field of study from an accredited college or university.
• 4 or more years of Epic experience.

Time Type: Full time

The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. See also Diversity, Equity & Inclusion. The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link [e-mail]. Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.

About The University of Kansas Health System As part of the region’s premier academic medical center, The University of Kansas Health System in Kansas City is a world-class healthcare provider and destination for complex care and diagnosis. We are driven by our commitment to service, continuous improvement and to the highest degree of excellence. Collaboration between physicians, nurses, researchers, educators and other professionals who share their expertise leads to exciting discoveries and life-changing treatments for the people we serve.