Reimbursement Analyst: Medicare & Medicaid Claims

Blue Cross & Blue Shield of 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

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.