Reimbursement Analyst

Blue Cross and Blue Shield of Kansas•Topeka, KS

3d•$24 - $29•Onsite

About The Position

The Reimbursement Analyst coordinates reimbursement activities involving federal and state government programs in combination with Blue Cross and Blue Shield of Kansas coverage. The role supports the department in meeting organizational and national standards and is based onsite at the company’s Topeka, Kansas office. No travel is required.

Requirements

High school diploma or equivalent.
At least 2 years of experience in health insurance claims operations, claims adjudication, or government program reimbursement, including experience with Medicare, Medicaid, coordination of benefits, eligibility, or payment adjustment activities.
Ability to communicate positively, verbally and in writing, with all levels of internal and external customers.
Detail orientation and ability to work with a high level of accuracy.
Ability to effectively use systems and tools commonly utilized within the department.

Nice To Haves

At least 2 years of previous experience as a BCBSKS claims examiner.
Knowledge of medical terminology.

Responsibilities

Adjudicate complex claims across multiple lines of business, focusing on contract alignment, regulatory compliance, and accuracy.
Manage Medicare and Medicaid reimbursement activities, including verifying reimbursement claim accuracy and coordinating refund requests.
Conduct eligibility research and verification.
Coordinate with government agencies, contractors, and other stakeholders to resolve claim, eligibility, and reimbursement issues.
Receive and respond to internal and external customer inquiries.
Provide detailed support and problem resolution to claims processing areas.
Complete adjustments as necessary.
Assist management and ACES system specialists in identifying and correcting errors and problems.
Coordinate other party liability reimbursement activities for government programs, as performed by claims examiners, adjustment auditors, OPL, and payment recovery correspondents.