Manager Claims Operations

1 week ago


Topeka, United States Blue Cross and Blue Shield of Kansas Full time

Job Summary:
The Claims Operations Manager will oversee the daily activities of the claims production unit/s (i.e., Data Capture, Underwritten Business, Prime, Medicare Supplemental, Dental, Other Party Liability (OPL), Medicare/Medicaid Secondary Payer (MSP), Federal Employee Program (FEP), State of Kansas (SEHP), Inter-plan Teleprocessing (ITS) HOME, ITS HOST, Adjustments, Payment Recovery, and Training) within the BCBSKS Claims department.

"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.
•Trust: Work for one of the most trusted companies in Kansas.
•Flexibility: Options to work onsite and hybrid available.
•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
•Inclusive Work Environment: We pride ourselves on fostering a diverse and inclusive workplace where everyone is valued and respected.
•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.

Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

Responsibilities:

  • Manage activities, workflow, and performance within the department to achieve department, divisional, and corporate objectives, and service levels.
  • Attends local and national meetings and serves on committees involving issues, policies, and procedures pertinent to department or divisional activities.
  • Identifies processing or administrative policies and procedures needed or changes recommended.
  • Maintains close liaison with other departments or divisions on matters pertaining to areas of responsibility.
  • Coordinates claim and recovery activities with other departments or divisions, as necessary.
  • Responsible for developing and implementing projects and procedures designed to achieve national, corporate, divisional, and department objectives.
  • Projects and trends future workload volumes and staffing requirements within the department.
  • Develops the annual budget for the department and monitors the judicious use of allocated funds.
  • Responsible for the selection, training, counseling, and salary administration of direct subordinates. Recognizes and rewards assigned employee.
  • Must comply with corporate compliance programs and be able to maintain confidentiality.
  • Must comply with and implement corporate information security policies, standards, and guidelines relative to access control.
Knowledge/Skills/Abilities
  • Communicates effectively.
  • Works collaboratively across the company and with external partners.
  • Manages complexity to effectively solve problems.
  • Holds self and others accountable.
  • Makes good and timely decisions with strong financial acumen.
  • Instills trust as a leader with honesty, integrity, and authenticity.
  • Organized, optimizes work processes, and can plan and prioritize work to align with department, division, and corporate goals.
  • Has strong customer focus, both internal and external.
Education and Experience:
  • High School diploma or equivalency - Required
  • Three years supervisory or management experience - Required
  • Bachelor's degree with emphasis on Business Administration, Mathematics, or Health Care Financing and Management - Preferred
  • Blue Cross and Blue Shield business insight - Preferred
Benefits & Perks
  • 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

Posting Close Date

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