Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.
You Belong At Blue
Why Join Us?
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.
Benefits & Perks
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
Job Summary
A health claims examiner is responsible for reviewing, evaluating, and processing health, drug, dental and/or ancillary product claims submitted by members or providers for insurance reimbursement. The job involves ensuring that claims are processed accurately and timely, in accordance with policy terms, industry regulations, and company guidelines.
This position is scheduled to start December 7, 2026.
Work Location:
This position will work remotely in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.
What you'll do
Accurately review, analyze, and verify healthcare claims submitted by policyholders or medical providers.
Ensure all necessary documentation, coding (International Classification of Diseases, Tenth Revision (ICD-10), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS)), and data are included and correct.
Check for eligibility, coverage, and applicable benefits as per policy terms.
Enter and process claims information into the system with precision and attention to detail.
Apply appropriate insurance guidelines, including deductibles, co-pays, co-insurance, and maximum coverage limits.
Approve or deny claims based on policy coverage, ensuring compliance with regulatory and company standards.
Perform adjustments to processed claims as needed for corrective action.
Correspond with healthcare providers, patients, and internal departments to clarify or resolve discrepancies.
Investigate and resolve complex or escalated claim issues, such as coding errors, benefit misunderstandings, or billing discrepancies.
Ensure compliance with state and federal healthcare regulations.
Supports core values, policies, and procedures
Maintain detailed and accurate records of all claims processed, including documentation for audits or reviews.
Meet individual and team performance targets related to claims processing speed, accuracy, and quality.
Participate in ongoing training to stay updated on changes in health insurance policies and claims processing technologies.
Monitor and work daily reports to ensure timely claim control.
Performs other duties that may be assigned from time to time
What you'll need
Education
High school diploma or equivalent required
Experience
Previous experience in healthcare claims processing, medical billing, medical terminology, or health insurance preferred
Knowledge, Skills and Abilities
Strong attention to detail and organizational skills.
Knowledge of medical claim processing, medical terminology, insurance policies, and coding standards (ICD, CPT).
Excellent communication skills, both written and verbal.
Ability to work efficiently under pressure and meet deadlines.
Critical thinking and problem solving skills
Office and/or computer system experience preferred
Compensation
$20.96 - $26.20 *Non-exempt, Grade 11*
Blue Cross and Blue Sh
Numbers & Facts
Location
Wichita, Kansas
Skills
Analysis Skillsunmatched
Billingunmatched
Claims Processingunmatched
Co-Paymentsunmatched
Coding Standardsunmatched
Communication Skillsunmatched
Computer Systemsunmatched
Corrective Actionunmatched
Current Procedural Terminology (CPT)unmatched
Dental Insuranceunmatched
Detail Orientedunmatched
Documentationunmatched
Federal Laws and Regulationsunmatched
Fitnessunmatched
Health Insuranceunmatched
Healthcareunmatched
Healthcare Common Procedure Coding System (HCPCS)unmatched
Healthcare Providersunmatched
ICD-10unmatched
Incentive Programsunmatched
Information Technology & Information Systemsunmatched
Insuranceunmatched
International Classification of Diseases (ICD)unmatched
Maintain Complianceunmatched
Medical Billingunmatched
Medical Terminologyunmatched
Organizational Skillsunmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Regulationsunmatched
Regulatory Complianceunmatched
Reimbursementunmatched
State Laws and Regulationsunmatched
Team Playerunmatched
Time Managementunmatched
Training Programunmatched
Training/Teachingunmatched
Vision Planunmatched
Work From Homeunmatched
Writing Skillsunmatched
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