Medical Economics System Specialist
Blue Cross Blue Shield Kansas

Job Info

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Blue Cross and Blue Shield of Kansas is looking for a Medical Economics Systems Specialist to add to our team. Medical Economics Systems Specialists are a team that manages the identification, research, testing, coordination, support, approval, and documentation of system development and modifications for the medical economics department, under the supervision of the Supervisor, Medical Economics Systems. This role acts as a liaison between the medical economics department, Information Services (IS), various business areas across the company, and the provider directories vendor. This role ensures the effective implementation and operation of provider systems.

"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."

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

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.
• Trust: Work for one of the most trusted companies in Kansas.
• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.

Compensation

$26.34-$31.30
Non-exempt Grade 13

• 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. The range may vary above or below the stated amounts.

What you'll do

• Serve as a central point of communication between Information Services (IS) and corporate users regarding medical economics related system development, problems, and modifications.
• Maintain a systematic knowledge of medical economics systems (provider pricing programs and systems, including alternative payment programs, Provider Entry System, provider directories and cost tools, etc), claims system, membership system, QMF, and outsourced service providers' systems used in the department.
• Perform in-depth testing of system problems, new systems and modifications to existing systems supporting departmental functions.
• Define and maintain test scenarios that are used for each system update.
• Evaluate, research and resolve user identified system problems and document the conclusions.
• Identify and create Service Requests (SR) for system enhancements and fixes.
• Maintains status/backlog documentation.

What you need

• High school graduate or equivalent required.
• Experience in setting up and conducting system tests required.
• 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.
• Technical Knowledge: Proficiency in healthcare system software, databases, and claims processing tools. Familiarity with Agile software development and project management methodologies. Proficient in SQL.
• Analytical Skills: Strong ability to analyze healthcare data and resolve system issues. Thorough understanding of system testing principles, including setting up test cases and verifying test results.
• Problem-Solving: Excellent troubleshooting skills with the ability to quickly identify and fix system-related problems. Strong analytical skills with ability to present facts logically.
• Communication: Clear written and verbal communication skills to interact with team members and train users.
• Regulatory Knowledge: Understanding of healthcare regulations, HIPAA compliance, and provider claim coding data (ICD, MS-DRG's, CPT, HCPCS).

Bonus if you have

• Bachelor's degree in computer science, Business Administration, Economics, Accounting, or similar preferred.
• Two years of experience in provider relations, medical economics, or operations (such as customer service, membership, claims) is strongly preferred.
• Exposure to provider claim coding data and systems testing 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

Pay Rate Type
Hourly

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