Remote OPL Claims Investigator

Blue Cross and Blue Shield of Kansas; United States; Hybrid; USD 30,000 - 37,000; Full time

Benefits offered by this job

Incentive pay program (EPIP)

Health/Vision/Dental insurance

6 weeks paid parental leave for new...

Fertility/Adoption assistance

2 weeks paid caregiver leave

401(k) plan matching up to 5%

Tuition reimbursement

Health & fitness benefits, discounts

Job summary

Blue Cross and Blue Shield of Kansas seeks an OPL Claims Correspondent to investigate and manage complex claims involving overlapping or duplicate coverage, auto/no-fault, workers’ compensation and subrogation. Responsibilities include research, adjustments, and detailed recordkeeping.

Position permits remote or onsite work under our Telecommuting Policy and requires Kansas/Missouri residency or relocation.

Qualifications

• High school diploma or equivalent required.
• Minimum 1 years’ experience of claims processing required.
• Minimum 1 years’ experience of BCBSKS Customer Service experience required.

Responsibilities

• Research and investigate claims to determine payment liability.
• Load notes/trailers from research for OPL investigations.
• Maintain detailed records of claims researched for audits or reviews.
• Refer claims for adjustments as needed for corrective action.
• Keep up to date on state law, contracts and policy guidance.

Skills

Verbal communication

Written communication

Attention to detail

Education

High school diploma or equivalent

Tools

Imaging

ACES

OTIS

MASK

Outlook

TROVE

Check Free

IS12

Client Letter

ITS

CSI

Membership system

Job description

Blue Cross and Blue Shield of Kansas seeks an OPL Claims Correspondent to investigate and manage complex claims involving overlapping or duplicate coverage, auto/no-fault, workers’ compensation and subrogation. Responsibilities include research, adjustments, and detailed recordkeeping.

Position permits remote or onsite work under our Telecommuting Policy and requires Kansas/Missouri residency or relocation.