OPL Claims Specialist - Remote (KS/MO)

Blue Cross & Blue Shield of Kansas, Inc.; Wichita (KS); Remote; USD 30,000 - 37,000; Full time

Benefits offered by this job

Health insurance

Vision insurance

Dental insurance

Parental leave 6 weeks

Fertility/adoption assistance

Caregiver leave 2 weeks

401(k) matching

Tuition reimbursement

Job summary

Blue Cross and Blue Shield of Kansas is seeking an OPL Claims Correspondent to investigate and manage complex claims involving overlapping or duplicate coverage, auto/no-fault, workers' compensation and subrogation.

Your role supports compliant claims operations through investigations, calculations, adjustments, and accurate documentation. Remote or onsite work is available for Kansas/Missouri residents ready to relocate if needed.

Qualifications

• High school diploma or equivalent required.
• 1+ years claims processing or BCBSKS customer service experience preferred.
• Knowledge of state laws and NAIC guidelines relevant to claims.

Responsibilities

• Research and investigate claims to determine payment liability (OPL).
• Load notes from research to ensure accurate payment of claims.
• Maintain detailed records of all claims researched for audits.
• Communicate with insureds, providers, and external vendors as needed.

Skills

Verbal communication

Written communication

Customer service

Attention to detail

Education

High school diploma or equivalent

Tools

Imaging

ACES

OTIS

MASK

Outlook

TROVE

IS12

CSI

Membership system

Job description

Blue Cross and Blue Shield of Kansas is seeking an OPL Claims Correspondent to investigate and manage complex claims involving overlapping or duplicate coverage, auto/no-fault, workers' compensation and subrogation.

Your role supports compliant claims operations through investigations, calculations, adjustments, and accurate documentation. Remote or onsite work is available for Kansas/Missouri residents ready to relocate if needed.