Dispute Resolution Specialist
4 days ago
The Dispute Resolution Specialist will be responsible for negotiating with non-contracting providers on behalf of the Professional Relations Department. This role will involve creating and submitting offers to the IDR entity in the event of failed negotiations.
Key Responsibilities- Develop and maintain general procedure documents for negotiations with non-contracting providers.
- Attend ongoing meetings with internal teams to discuss negotiation strategies and updates.
- Establish and maintain direct contact with providers, attorneys, accountants, billing agents, IDR entities, and state insurance departments to negotiate claims and resolve disputes.
- Research claim adjustments, verify correct provider payment per LOA/IDR determination, and maintain an ongoing understanding of reimbursement levels and issues.
- Manage IDR arbitration and ensure timely resolution of disputes.
- Bachelor's Degree in Business, Economics, Education, or a similar field.
- Minimum of 3 years of work experience with Blue Cross and Blue Shield of Kansas.
- Knowledge of the Consolidated Appropriations Act and No Surprise Bill Legislation.
- Competitive salary range: $60,800 - $72,000.
- Exempt grade 14.
- Excellent benefits package, including health, vision, and dental insurance, 6 weeks of paid parental leave, fertility/adoption assistance, 2 weeks of paid caregiver leave, 5% 401(k) plan matching, tuition reimbursement, and health and fitness benefits.
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Insurance Claims Specialist
2 weeks ago
Topeka, Kansas, United States BCforward Full timeInsurance Claims SpecialistCompany Overview: BCforward is a prominent firm dedicated to delivering exceptional professional services and workforce management solutions to organizations globally.Position Overview: We are seeking a dedicated Insurance Claims Specialist to join our team. This role involves managing a diverse range of claims and ensuring...
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Network Relations Consultant
4 days ago
Topeka, Kansas, United States Elevance Health Full timeJob DescriptionJob Summary: We are seeking a skilled Network Relations Consultant to join our team at Elevance Health. As a key member of our organization, you will be responsible for developing and maintaining positive relationships with healthcare providers in the Kansas region.Key Responsibilities:Develop and implement strategies to improve provider...
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Family Court Conciliation Specialist
7 days ago
Topeka, Kansas, United States Kansas Judicial Branch Full timeJob SummaryWe are seeking a highly skilled and experienced professional to join our team as a Court Services Officer I - Family Mediator. This role will involve working with the Third Judicial District's Domestic/Family Court divisions to assist parents in divorce, post-divorce, and paternity cases resolve conflicts regarding child custody, residency, and/or...
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Procurement Specialist
2 weeks ago
Topeka, Kansas, United States Veterans Affairs, Veterans Health Administration Full timePosition Overview:The Veterans Affairs, Veterans Health Administration is dedicated to fostering a diverse and inclusive workplace. We aim to cultivate an environment that encourages professional development and collaboration.Role Summary: The individual in this role will function as a Procurement Specialist within the Logistics Service of a Veteran Affairs...
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Technical Support Specialist
2 weeks ago
Topeka, Kansas, United States Intermountain Health Full timePosition Overview:The Technical Support Specialist role is essential for maintaining efficient computer operations, enabling end-users to perform their business and clinical functions effectively. This position involves receiving, prioritizing, documenting, and actively resolving user support requests. Problem-solving may require utilizing diagnostic tools...
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Product Quality Assurance Specialist
2 days ago
Topeka, Kansas, United States Reser's Full timeJob SummaryWe are seeking a highly skilled Product Quality Assurance Specialist to join our team at Reser's. As a Product Quality Assurance Specialist, you will be responsible for monitoring and auditing the product manufacturing process to ensure product quality.Key ResponsibilitiesMonitor food manufacturing processes to ensure product quality and...
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Provider Engagement Specialist III
4 days ago
Topeka, Kansas, United States Centene Corporation Full timeJob SummaryWe are seeking a highly skilled Provider Engagement Specialist III to join our team at Centene Corporation. As a key member of our healthcare team, you will be responsible for building and maintaining strong relationships with our network providers, driving performance improvement, and ensuring seamless operations.Key ResponsibilitiesAct as a...
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Claims Assessment Specialist
2 weeks ago
Topeka, Kansas, United States Sedgwick Full timeJoin Our Team as a Claims Assessment Specialist At Sedgwick, we prioritize the well-being of our employees, fostering a culture of support and inclusivity. A career with us means you will be part of a community that values flexibility and personal growth. We are dedicated to making a meaningful impact every day, ensuring that our team members have the...
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Senior Logistics Operations Specialist
2 weeks ago
Topeka, Kansas, United States World Fuel Services Full timePosition Overview:As a Senior Logistics Operations Specialist at World Fuel Services, you will play a pivotal role in overseeing intricate logistics activities with a high degree of autonomy. Your expertise will be essential in addressing transportation challenges and enhancing customer service.Key Responsibilities:Issue Resolution: Proactively tackle...
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Event Security Specialist
3 days ago
Topeka, Kansas, United States BEST Crowd Management Full timeJob Title: Event Security SpecialistCompany: BEST Crowd ManagementLocation: Various VenuesPay: $15 / hrJob Type: Part-timeSummary:We are seeking a highly skilled and adaptable Event Security Specialist to join our dynamic team at BEST Crowd Management. As an Event Security Specialist, you will be responsible for ensuring the safety and security of event...
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Family Law Associate Attorney
2 weeks ago
Topeka, Kansas, United States Jobot Full timeA reputable law firm is seeking a dedicated Family Law Associate Attorney to enhance their legal team.About Us:We are a well-established firm known for our commitment to providing exceptional legal services in family law. Our focus is on fostering a supportive environment for our employees while ensuring our clients receive the highest quality of...
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Healthcare Consultant II
4 days ago
Topeka, Kansas, United States Umanist Staffing LLC Full timeJob DescriptionUmanist Staffing LLC is seeking a skilled Healthcare Consultant II - Telehealth Specialist to join our team. As a key member of our organization, you will play a critical role in developing and implementing effective health services strategies, policies, and programs that drive quality healthcare delivery and establish a competitive business...
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Youth Independence Support Specialist
2 weeks ago
Topeka, Kansas, United States Pathway Family Services LLC Full timeAverage hourly rate is $15.00 (including wage, incentives, bonuses, overtime, shift differential, etc.) Independent Living Support Worker Pathway Family Services, LLC. offers vital resources for youth and families through its Independent Living Program, TRAIL (Teens Reaching Adult Independent Living), Psychiatric Residential Treatment Facility, Qualified...
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Bodily Injury Claims Specialist
2 weeks ago
Topeka, Kansas, United States Farmers Group Inc. Full timePosition OverviewThis role is responsible for managing homeowner insurance claims that involve complex policy interpretation, thorough investigation, damage evaluation, liability assessment, and negotiation of settlements.Key ResponsibilitiesThe selected candidate will oversee the entire claims process and act as the main point of contact to ensure efficient...
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Continuous Improvement Specialist
4 days ago
Topeka, Kansas, United States Mars Incorporated Full timeAbout the RoleMars Incorporated is seeking a highly skilled Continuous Improvement Specialist to join our team. As a key member of our organization, you will be responsible for leading loss elimination initiatives and supporting our Manufacturing Excellence (MSE) pillars.Key ResponsibilitiesLead loss elimination initiatives within an MSE team and support all...
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Bodily Injury Claims Specialist
2 weeks ago
Topeka, Kansas, United States Farmers Group Inc. Full timePosition OverviewThis role is responsible for managing homeowner insurance claims that involve complex policy interpretation, thorough investigation, damage assessment, liability evaluation, and negotiation of settlements.Key ResponsibilitiesThe selected candidate will oversee the entire claims process, acting as the main point of contact to ensure effective...
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Community Advocacy Coordinator
2 weeks ago
Topeka, Kansas, United States Elevance Health Full timeJob Overview Position Title : Ombudsman Liaison Work Arrangement : This role operates in a hybrid format, combining remote work with office presence. Candidates should ideally reside within a reasonable commuting distance from Elevance Health locations. The Ombudsman Liaison plays a pivotal role in facilitating connections between members and local...
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Clinical Nurse Specialist
2 weeks ago
Topeka, Kansas, United States Stormont Vail Health Full timeJob OverviewKey ResponsibilitiesDelivers direct patient care in accordance with the state's nursing regulations. Conducts thorough assessments and ongoing data collection, concentrating on both physiological and cognitive aspects of patient health.Develops a prioritized, goal-oriented care plan tailored to the patient's immediate concerns and anticipated...
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Bodily Injury Claims Specialist
2 weeks ago
Topeka, Kansas, United States Farmers Group Inc. Full timePosition OverviewThis role is responsible for managing homeowner insurance claims related to bodily injuries, requiring comprehensive policy analysis, thorough investigations, and effective negotiation skills.Key ResponsibilitiesThe selected candidate will oversee the entire claims process, acting as the primary liaison for claim resolution. Responsibilities...
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Human Resources Specialist
1 week ago
Topeka, Kansas, United States HR Partners Full timeCompany: HR PartnersPosition: Human Resources CoordinatorJob Classification: Full-time, ExemptWork Schedule: FlexibleReporting Relationship: Directly reports to the PresidentOverview: As a Human Resources Coordinator at HR Partners, you will be instrumental in overseeing various human resources functions for our clients. Your role will involve collaborating...