Provider Reimbursement Specialist

3 weeks ago


Topeka, Kansas, United States Blue Cross Blue Shield of Kansas Full time
Provider Reimbursement Analyst

Blue Cross and Blue Shield of Kansas is seeking a skilled Provider Reimbursement Analyst to join our Medical Economics team. As a key member of our team, you will play a crucial role in designing, extracting, and analyzing large datasets to identify opportunities to reduce healthcare costs and utilization through provider reimbursement initiatives.

Key Responsibilities:
  • Develop technical studies, analyses, and fiscal impacts to inform pricing and methodologies for institutional and professional provider payment programs.
  • Collaborate with cross-functional teams to integrate provider reimbursement strategies with broader financial and operational goals.
  • Design and prepare financial exhibits to detail the cost of MAP increases.
  • Assist with provider contract reimbursement and policy audits, and conduct claims recovery activities.
  • Develop queries to extract claim data for payment accuracy and perform claims recovery activities.
Why Work with Us?

We offer a total rewards package that promotes the idea of family first, including paid time off and family first leave. Our dynamic work environment fosters a diverse and inclusive workplace where everyone is valued and respected. You will have opportunities for professional growth and development through our internal Blue University and external opportunities. Your work will directly contribute to the health and well-being of Kansans.

This position is eligible to work 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.



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