Lead Claims Specialist & Process Innovator

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

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.