Reimbursement Analyst

Kansas Inc.; Topeka (KS); Presencial; USD 33.000 - 39.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance (Vision/Dental)

6 weeks parental leave

Fertility/Adoption assistance

2 weeks caregiver leave

401(k) plan matching up to 5%

Tuition reimbursement

Health & fitness benefits

Descripción de la vacante

Blue Cross and Blue Shield of Kansas is seeking a Reimbursement Analyst to coordinate reimbursement activities across government programs in combination with our coverage. The role supports compliance with national standards and contributes to efficient claims processing in a fast-paced environment.

You will work onsite in Topeka, KS, handling Medicare/Medicaid workflows, eligibility checks, and collaboration with government agencies and internal teams to ensure accurate reimbursements.

Formación

• High school diploma or equivalent required.
• Minimum 2 years' experience in health insurance claims operations, claims adjudication, or government program reimbursement.
• Minimum 2 years' experience as a BCBSKS claims examiner preferred.

Responsabilidades

• Adjudicates complex claims across multiple lines of business with a focus on contract alignment, regulatory compliance, and accuracy.
• Manages Medicare and Medicaid reimbursement activities including verifying accuracy on reimbursement claims and coordinating refund requests.
• Conducts eligibility research and verification.
• Coordinates with stakeholders including government agencies and contractors to resolve claim, eligibility, and reimbursement issues.
• Receives and responds to external and internal customer inquiries.
• Provides detailed support and problem resolution to all claims processing areas.
• Completes adjustments as necessary.
• Assists management and ACES system specialists in the identification and correction of errors and problems.

Conocimientos

Verbal and written communication

Medical terminology

Detail oriented

Systems knowledge

Educación

High school diploma or equivalent

Herramientas

ACES system

Descripción del empleo

Why Join Us?

Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.

Family Comes First: Total rewards package that promotes the idea of family first for all employees.

Paid vacation and sick leave with paid maternity and paternity available immediately upon hire

Professional Growth Opportunities: Advance your career with ongoing training and development programs.

Dynamic Work Environment: Collaborate with a team of passionate and driven individuals in a work environment that promotes flexibility.

Trust and Stability: Work for one of the most trusted companies in Kansas with over 80 years of commitment, compassion and community.

Inclusive Work Environment: We pride ourselves on fostering a workplace where everyone is valued and respected.

Benefits & Perks

• Base compensation is only one component of your competitive Total Rewards package
• Incentive pay program (EPIP)
• Health/Vision/Dental insurance
• 6 weeks paid parental leave for new mothers and fathers
• Fertility/Adoption assistance
• 2 weeks paid caregiver leave
• 401(k) plan matching up to 5%
• Tuition reimbursement
• Health & fitness benefits, discounts and resources

Job Summary

The Reimbursement Analyst is responsible for coordinating reimbursement activities based on federal and state government programs in combination with Blue Cross and Blue Shield of Kansas coverage. The position supports the department in meeting organizational and national standards.

Work Location

This position is onsite located in our Topeka, KS office.

What you'll do

• Adjudicates complex claims across multiple lines of business with a focus on contract alignment, regulatory compliance, and accuracy.
• Manages Medicare and Medicaid reimbursement activities including verifying accuracy on reimbursement claims and coordinating refund requests.
• Conducts eligibility research and verification.
• Coordinates with stakeholders including government agencies and contractors to resolve claim, eligibility, and reimbursement issues
• Receives and responds to external and internal customer inquiries.
• Provides detailed support and problem resolution to all claims processing areas.
• Completes adjustments as necessary.
• Assists management and ACES system specialists in the identification and correction of errors and problems.
• Coordinates other party liability reimbursement activities for government programs, as performed by claims examiners, adjustment auditors, OPL and payment recovery correspondents.

What you'll need

Education

High school diploma or equivalent required.

Experience

Minimum 2 years' experience In health insurance claims operations, claims adjudication, or government program reimbursement, including experience with Medicare, Medicaid, coordination of benefits, eligibility or payment adjustments activities required Minimum 2 years' experience previous experience as a BCBSKS claims examiner preferred

Travel

No travel

Knowledge, Skills and Abilities

Ability to communicate positively, both verbal and in writing, with all levels of internal and external customers required. Knowledge of medical terminology is preferred. Must be detail oriented and work with a high level of accuracy. Ability to effectively use various systems and tools commonly utilized within the department.

Compensation

$24.11 - $28.60 hourly Non-Exempt 12 Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

Our Commitment to Connection and Belonging

At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of connection and belonging, where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law. Our Commitment to Connection and Belonging At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of connection and belonging, where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law. Blue Cross and Blue Shield of Kansas conducts pre-employment drug screening, criminal conviction check, employment verifications and education as part of a conditional offer of employment.

For more than 70 years, Blue Cross and Blue Shield of Kansas has built a reputation of trust. As we move forward in this new era of health care we want to continue that tradition. Whether a member needs Blue Cross to cover an annual check-up or give them peace of mind during a major medical crisis, we want our members to know they can trust BCBSKS to meet their needs. Our mission: Being the insurer Kansans trust with their health.

Our Commitment to Connection and Belonging At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of connection and belonging, where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law. Blue Cross and Blue Shield of Kansas conducts pre-employment drug screening, criminal conviction check, employment verifications and education as part of a conditional offer of employment.