Title: Benefit Coding/Group Master Auditor, #2012119
Application Deadline: May 17, 2012
**2 positions available**
Job Summary:
Responsible for establishing benefit coding and loading rates for new and renewing groups. The benefits/rates determine how claims are processed, premiums are billed, what contract language is provided to the customer and how inquiries are answered. Responsible for SGRR benefit change specifications. Responsible for establishing new groups, processing renewals with benefit changes or rate changes on existing groups and miscellaneous group master work in MASK. Set up applications on new groups, work change forms and option forms associated with a group's renewal.
Required:
- High school graduate or equivalent.
- Excellent verbal and written communication skills are required, with the ability to interact positively with all levels of customers.
- Excellent human relation skills are required, with the ability to handle difficult situations in a positive and professional manner.
- Ability to understand and interpret contractual language to ensure that benefits are coded according to what has been sold to the group.
- Must have the ability to understand the complexities involved in the setup and benefit coding of groups with non-standard benefits and administration, including thorough knowledge of the entire group enrollment process from marketing to claims payment.
- Must have the ability to manage multiple tasks and work independently to meet individual, department and corporate goals.
- Must have the ability to work under strict time constraints with frequent interruptions while maintaining a high degree of accuracy.
- Must have the initiative to independently resolve marketing inquiries in a timely manner with little to no supervision.
- Strong organizational skills are required, with the ability to constantly re-evaluate existing situations and develop long-term solutions for providing optimal customer satisfaction.
- Ability to work in a team environment.
- Strong math and reasoning skills.
- Knowledge required for the operation of a PC and calculator.
- Ability to type 30 wpm.
- Proven record of low unscheduled absences.
Preferred:
- Knowledge of online systems to include MASK, KCAPS, OTIS, Imaging, ESM, Trove and OnDemand.
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Title: Membership Auditor, #2012087
Application Deadline: May 20, 2012
Job Summary:
Establish and maintain group and member records within the Membership systems to include initial enrollment and changes to existing enrollment following corporate policies and procedures. Coordinate with Finance Auditor on billings and the posting of premiums. The job includes communicating with internal staff, field staff, members and group leaders. Responsible for meeting and maintaining departmental and corporate goals.
Qualifications:
- High school graduate or equivalent.
- Ability to type at least 30 wpm.
- Must have excellent verbal and written communication skills, with the ability to interact positively with all levels of clients and staff, both internally and externally.
- Math skills with decimals and fractions.
- Knowledge required for operation of a PC and calculator.
- Ability to work in a team environment.
- Must be able to manage multiple tasks and work independently to meet individual goals as well as department and corporate goals.
- Ability to work under time constraints with frequent interruptions.
- Proven record of low unscheduled absences.
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Title: ICD-10 Coding Specialist, #2012064
Application Deadline: May 16, 2012
Job Summary:
Under the direction of the ICD-10 Nurse, the ICD-10 Coding Specialist primary responsibility is to provide detailed coding direction related to ICD-10 for Blue Cross and Blue Shield of Kansas. This position will assist with code identification from ICD-9 to ICD-10 and adjustments to current coding policies and procedures and recommendations to allow for business direction related to future enhancements allowed through use of ICD-10. This will include assisting with coding recommendations in policies related to predeterminations, claims, inquiries, and standards of medical practice, individual contractual benefits, reimbursement, system edits, correct coding and other processes that relate to claims adjudication. It will also include assistance with code determination in medical review areas, information systems, provider contracts, vendor contracts, system edits, FEP and ITS guidelines and policy revisions. The ICD-10 Coding Specialist position will have a wide circle of visibility and will report to/work closely with an ICD-10 Nurse position and activities related to conducting code analysis and adjustments necessary to support BCBSKS, our provider community and customers.
Required:
- Future ICD-10 certification, upon program availability from Coding Industry will be required.
- Experience navigating the medical record, deciphering medical terminology and applying coding guidelines.
- Excellent verbal and written communication skills required with the ability to interact positively with all levels of internal staff and external customers.
- Possess the ability to build a code choice based upon detailed medical or claims data, including application of gender, age, place or service and documentation by using all types of codes to include ICD-9 diagnoses and procedures codes and CPT in determining and recommending changes related to ICD-10 is required. Ability to apply use of gender, age, place of service impact in code choice determination is required.
- Understanding of Healthcare Payer claims data, HIPAA standard transaction and code set standards, industry code classifications such as ICD-9, CPT to ICD-9 Maps, ICD-10, HCPC coding, National Drug Codes, etc. Good interpersonal skills and customer service skills. Must possess excellent communication skills, both oral and written. Strong facilitation and presentation skills. Strong customer focus. Must be willing to take a coding examination.
- Basic computer knowledge is required to include navigation through spreadsheets such as excel or use of word documents.
- Knowledge of provider and member contracts along with an understanding of the application of related medical and reimbursement policies and procedures within claims, membership, provider, precertification and referral systems.
Preferred:
- College degree with a background in the health information or medical education is preferred.
- Current American Academy of Professional Coders (AAPC) credentials as a certified professional coder (CPC) or Certified Professional Medical Auditor (CPMA) preferred. Must obtain this certification within eighteen months of employment and keep certification active.
- Two years of coding experience with ICD-9 diagnosis and procedures and CPT codes.
- Knowledge of LAN applications, Data Retrieval software, and Internet proficiency to assist with data gathering.
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Title: Intern, Workforce and Leadership Development, #2012114
Application Deadline: May 18, 2012
Job Summary:
The Workforce and Leadership Development intern will aid in classroom and training preparation, assist with both corporate and mobile library administration, research and evaluate electronic educational resources and software, extract data from e-personality and format into excel, and aid in the research and development of e-learning modules.
Required:
- Must be enrolled in an accredited college or university (communications or a related field of study).
- Strong written and verbal communication skills.
- Strong PC skills (Windows operating system, e-mail, internet browsing and research).
- Working knowledge of Microsoft Office (Word, PowerPoint, Excel).
Preferred:
- Working knowledge of Microsoft Access.
- Experience using e-learning development tools (i.e. Adobe Creative or E-Learning suite, Adobe Captivate, Raptivity).
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