Reimbursement Analyst

Blue Cross and Blue Shield of Kansas • Topeka, KS

2d • 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. Compensation is $24.11–$28.60 per hour, and the position is non-exempt.

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 adjustments.
• Ability to communicate positively, verbally and in writing, with internal and external customers at all levels.
• Detail-oriented, with a high level of accuracy.
• Ability to effectively use systems and tools commonly utilized within the department.

Nice To Haves

• Previous experience as a BCBSKS claims examiner.
• Knowledge of medical terminology.

Responsibilities

• Adjudicate complex claims across multiple lines of business, ensuring 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 external and internal customer inquiries.
• Provide detailed support and problem resolution to claims processing areas.
• Complete claim 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.

Benefits

• Incentive pay program (EPIP).
• Health, vision, and dental insurance.
• Six weeks of paid parental leave for new mothers and fathers.
• Fertility and adoption assistance.
• Two weeks of paid caregiver leave.
• 401(k) plan with matching up to 5%.
• Tuition reimbursement.
• Health and fitness benefits, discounts, and resources.
• Paid vacation and sick leave.
• Paid maternity and paternity leave available immediately upon hire.
• Ongoing training and development programs.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED