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. 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 Responsible for independent non-clinical review of claims and inquiries using contracts, medical policies, internal guides, and desk process. Ensure claims and inquiries are processed timely and accurately according to contract, corporate, and federal guidelines. Responsible for identifying when a non-clinical review should be elevated to a higher level of review, i.e., nurse consultant, management, consultants. Responsible for researching history, identifying appropriate guidelines, and formatting clear concise question(s) for claims needing nurse, management, or outside consultant review. Responsible for providing support to internal staff (i.e., Marketing, Hotline, CSC), regarding questions about coding, claim processing, and pricing issues. Responsible for maintaining current knowledge regarding coding, contract language, system editing, and pricing guidelines. Responsible for identifying areas of aberrant utilization for provider education, guideline, and system changes. Participates in department and cross-divisional teams. Must follow URAC standards as required for essential job functions. High school diploma or equivalent required Minimum 3 years' experience in BCBSKS Claims or Customer Service required or Minimum 2 years' experience in medical coding and AAPC certification required or Minimum 3 years' experience in medical coding required Certified Coder-AHIMA or AAPC within three years of hire required No travel Must be self-directed with the ability to make independent decisions and prioritize personal and employee production activities. Must have strong computer skills to operate effectively with company systems and programs. Must be able to maintain a productive and professional relationship with multiple cross departmental and divisional teams. Must have a strong analytical background. Must be able to use medical terminology/medical diagnostic and procedure information, ICD-10, CPT, HCPCS coding to accurately review and complete claims activity. Thorough knowledge of multiple product lines, contracts, and related operating policies with preference to FEP, Blue Choice, State of Kansas, and Interplan Teleprocessing System (ITS). 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. To view full details and how to apply, please login or create a Job Seeker account