The FEP Claims Systems Specialist is responsible for maintaining and enhancing the technical systems and applications used to manage healthcare claims functions specifically for the Federal Employee Program and the Postal Service Health Benefits Program. This role requires a combination of technical knowledge, project management skills, and an understanding of healthcare systems and operations.
This position will be onsite for the first 6 weeks of training then is eligible to work onsite, hybrid (9 or more days a month onsite), or remote 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.
Compensation
$23.00- $27.30 Non- Exempt 12 • 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.
Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.
What you'll do
Responsibilities:
System Management and Support:
Maintain, update, and troubleshoot healthcare systems related to the FEP and PSHBP programs.
Ensure data integrity and accuracy in FEP/PSHBP claims processing and eligibility systems.
Coordinate with IT and operational teams to resolve system issues and ensure seamless functionality.
Project Management:
Participate in system upgrade projects, implementing new functionalities and enhancements to support FEP/PSHBP operations.
Work with cross-functional teams, including developers, analysts, and business leaders, to ensure project deliverables are met.
Assist in the development of project plans, timelines, and documentation for system improvements.
Claims and Eligibility System Support:
Collaborate with claims and eligibility teams to identify system needs and ensure efficient processing of claims.
Conduct testing and validation of system changes to ensure they align with federal guidelines and standards.
Develop and update workflows to enhance system capabilities for claims processing.
Data Analysis and Reporting:
Analyze healthcare data from the system to identify trends, issues, and opportunities for improvement.
Generate regular and ad-hoc reports to support decision-making by management.
Monitor system performance and produce detailed analysis for system audits or compliance checks.
Customer Support and Training:
Provide technical assistance to internal teams and users on system functionalities.
Train staff on the use of new or updated system features related to the programs.
Assist in creating user manuals, guidelines, and training materials for healthcare system applications.
Compliance and Regulations:
Ensure systems comply with federal healthcare regulations and data privacy laws (e.g., HIPAA).
Stay up to date with FEP/PSHBP guidelines and health plan requirements, ensuring system modifications adhere to these standards.
Collaboration and Communication:
Serve as a liaison between IT and operations teams, ensuring smooth communication and system functionality across departments.
Communicate system issues and updates to key stakeholders in a timely manner.
What you need
Knowledge/Skills/Abilities:
Technical Knowledge: Proficiency in healthcare system software, databases, and claims processing tools.
Analytical Skills: Strong ability to analyze healthcare data and resolve system issues.
Problem-Solving: Excellent troubleshooting skills with the ability to quickly identify and fix system-related problems.
Communication: Clear written and verbal communication skills to interact with team members and train users.
Regulatory Knowledge: Understanding of healthcare regulations, FEP guidelines, and HIPAA compliance.
Education and Experience:
High school education or equivalent is required.
Two years for FEP knowledge is required.
One year of claims processing is required.
Familiarity with project management tools and healthcare system integration is preferred.
Physical Requirements:
Office setting, with possible remote or hybrid work opportunities depending on the department.
Some meetings, trainings, demonstrations, etc. may require in person attendance.
May involve long periods of time working on a computer.
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
Our Commitment to Diversity, Equity, Inclusion, and Belonging
At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of diversity, equity, inclusion, and belonging (DEIB), where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law.
We believe that embracing diversity and authentically promoting inclusion, equity, and belonging among our team members is crucial to our collective success. By intentionally recruiting, developing, and retaining a diverse pool of talent, we cultivate an environment where everyone feels valued, heard, and empowered to contribute. Accommodations are available for applicants with disabilities upon request, ensuring an inclusive and accessible hiring process for all.
