Blue Cross and Blue Shield of Kansas is looking to for a team member in our operations department to serve as OPL Claims Correspondent. This team member will Investigate claims involving duplicate coverage, blue on blue, auto no-fault, and workers’ compensation. Initiate adjustments when necessary. Daily activity deals with all Blue Cross and Blue Shield contracts/lines of business and performing OPL calculations.

This position is eligible to work remotely (8 or less days a month onsite) or hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate 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
• Lead and Inspire: Guide and mentor your team to achieve their full potential and success.
• Balance: paid vacation and sick leave with paid maternity and paternity available immediately upon hire
• Real World Experience: You will work hand in hand with our team in learning our business and applying your classroom learning.
• Networking Opportunities: Participate in our corporate intern program and network with other interns at BCBSKS to enhance your learning opportunity.

$19.81- $23.50
Non- Exempt Grade 11

• 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.

• Investigate claims received within the department to make accurate determination of Blue Cross and Blue Shield of Kansas payment liability (Other Party Liability).
• Properly load notes/trailers and research claims based on information received from insureds/providers.
• Recognize and refer policy and technical problems for management/supervisory action or Help Desk assistance. Provide input and assistance for system improvements.
• Perform online claim maintenance activity to records which result in system “kick-outs” of claims needing OPL involvement or to allow the accurate payment of claims.
• Analyze inquiry to determine course of action necessary and order/review related research materials when necessary.
• Initiate phone calls to providers, other insurance carriers, and groups, to obtain information or clarify circumstances.
• Remain current on state law, corporate contract and policy, and NAIC guidelines relative to application of contract benefits for auto no-fault, workers’ compensation, duplicate coverage and subrogation.
• Must comply with and implement corporate information security policies, standards, and guidelines relative to access control.
• Perform Job related special projects as assigned

• High school graduate or equivalent is required.
• One year claims experience or One year BCBSKS Customer Service Representative experience required.
• Knowledge of Worker Compensation and Kansas Auto No- fault laws are preferred
• College or training courses in medical terminology preferred
• Knowledge of IC10 Coding is preferred

• 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

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