- Professional
- Bureau à Topeka
“This position is eligible to work onsite or hybrid (9 or more days a month onsite), or remote in accordance with our Telecommuting Policy. Applicants must reside in Kansas, Missouri or be willing to relocate to another approved state as a condition of employment.”
Why Join Us?
• Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.
• Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
• Stability: 80 years of commitment, compassion, and community
• Networking Opportunities: Participate in our corporate intern program and network with other interns at BCBSKS to enhance your learning opportunity.
Compensation
$23.58- $29.40
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.
Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.
What you’ll do
Responsibilities:
• Provide regular reports on the Medicare Advantage and Medicare Prescription Drug programs.
• Reviews and confirms vendor eligibility, claims, benefits, and inquiries using relevant vendor systems.
• Research, resolve, and respond to inquiries and correspondence by telephone, written communication, or in person. These inquiries may be initiated by internal staff or vendor partners and may address a wide range of topics including, but not limited to, contract benefits, coverage changes, eligibility, claims, provider networks, payments, and appeals.
• Prepare CMS required documents for the Medicare Advantage and Prescription Drug programs.
• Develop and maintain desk level operational processes for the Medicare Advantage and Medicare Prescription Drug programs.
• Oversee the process for reviewing and approving member communications.
• Develop and maintain dashboards that are used to monitor the performance of the Medicare Advantage and Medicare Prescription Drug programs.
• Manage the Jira ticketing system.
What you need
Knowledge/Skills/Abilities:
• Uses critical thinking skills to determine course of action needed to identify issues and find
resolutions.
• Strong computer skills to operate effectively with company systems and programs are required.
• Excellent communication skills, both written and verbal, with the ability to communicate effectively with internal / external partners and members is required.
• Technical skills to perform system testing preferred.
• Responsible for threading customer experience into all aspects of the job.
• Must be able to prioritize and balance workload to ensure a timely and accurate response to both internal and external customers.
• Promote good working relations and a positive work environment with both internal and external customers.
Education and Experience:
• High school education or its equivalent required.
• Three years' experience either at a health payor, medical office or BCBSKS experience in quality checking claims, eligibility or inquiries required.
• Experience in working with Medicare programs is preferred
Physical Requirements:
• Must operate a Personal Computer (PC) at least 95% of the day in which a sitting/stationary position is required.
• While performing the duties of this job, the employee is regularly required to talk or hear.
Benefits & Perks
- Base pay 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
- 5% 401(k) plan matching
- Tuition reimbursement
- Health & fitness benefits, discounts and resources
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.
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