Top 155 Claims processing Jobs in Overland Park, Ks

Carelon Payment Integrity Manager - Kansas
Elevance Health —Overland Park, KS
- Hybrid work
- Nursing
- Management
- Bachelor of Science
- Employee stock purchase plan
- Paid holidays
5d
HR Generalist
1A Auto Inc —Olathe, KS
- Full-time
- Customer service
- 5 years
- Bachelor of Science
4d
Claims Intake Administrator
Performance Contracting —Lenexa, KS
- $51,300 - $69,000 a year
- Background check
- Microsoft Excel
- Microsoft Outlook
- AD&D insurance
- Paid holidays
Benefit Authorizer (Central Processing) Direct Hire Authority
US Social Security Administration —Kansas City, MO
- $51,283 - $66,670 a year
- Online Application
- Background check
- Pass drug screening
- Office
Reimbursement Coordinator - Home Health
Wellsky —Overland Park, KS
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Home Health
- Paid holidays
- Health insurance
Operations Processor - Debit Fraud Case Processing
U.S. Bank National Association —Overland Park, KS
- $20.00 - $22.50 an hour
- Full-time
- Research
- Mid-level
- Office
- Paid holidays
- Disability insurance
9d
Patient Billing Representative
Five Star Call Centers —Overland Park, KS
- $14 an hour
- Full-time
- Remote
- Background check
- HIPAA
- English
- Paid training
12d
Workers’ Compensation Medical Only Claim Representative
CCMSI —Overland Park, KS
- $20 - $21 an hour
- Monday to Friday
- Hybrid work
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Disability insurance
RCM Specialist
KVC Health Systems —Olathe, KS
- $20 - $24 an hour
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Work from home
Quick Apply
CUSTOMER SERVICE REP
THE EPOCH GROUP LC —Overland Park, KS
- Full-time
- Remote
- Basic math
- HIPAA
- English
Patient Financial Advisor
The University of Kansas Health System —Kansas City, KS
- Full-time
- Microsoft Word
- Microsoft Excel
- Hospital
Patient Accounting Rep II -- Customer Service
The University of Kansas Health System —Lenexa, KS
- Full-time
- Mid-level
- High school diploma or GED
- 1 year
Specialty Billing Technician
Walgreens —Kansas City, MO
- $22 - $29 an hour
- Full-time
- Writing skills
- Mid-level
- High school diploma or GED
Credit Dispute Specialist - Fidelity
U.S. Bank National Association —Overland Park, KS
- $20.00 - $24.38 an hour
- Full-time
- Research
- Mid-level
- Office
- Paid holidays
- Disability insurance
6d
Medicaid Billing & Compliance Specialist (KCK, Topeka, Wichita)
FosterAdopt Connect —Kansas City, KS
- $46,000 - $50,000 a year
- Full-time
- Mid-level
- Administrative experience
- High school diploma or GED
Quick Apply
Benefit Authorizer (Central Processing) Direct Hire Authority
Social Security Administration —Kansas City, MO
- $50,969 - $66,670 a year
- Full-time
- Mid-level
- Office
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
12d
Field Service Representative I - Lenexa, KS
Solventum —Lenexa, KS
- $40,480 - $55,660 a year
- Extended hours
- Hospital
- High school diploma or GED
- Driver's License
- Health savings account
- Disability insurance
Risk Claims Manager
CrossCountry Freight Solutions, Inc. DBA CCFS —Kansas City, KS
- $85,000 - $95,000 a year
- Full-time
- 7 years
- Windows
- Analysis skills
Quick Apply
6d
File Processing Admin
HighGround —Lenexa, KS
- From $18 an hour
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Office
- Health insurance
- Paid time off
Quick Apply
5d
MEDICAL CLAIMS ADJUSTER
Wilson-McShane Corp —Kansas City, MO
- $28.80 an hour
- Full-time
- Mid-level
- 2 years
- AD&D insurance
- Paid holidays
Quick Apply
10d

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Carelon Payment Integrity Manager - Kansas

Elevance Health -
Overland Park, KS

Apply Now

Job Details

5 days ago

Benefits

Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Management

Full Job Description

Carelon Payment Integrity Manager - Kansas

Location: Kansas

Hybrid: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Carelon Payment Integrity Manager - Kansas is responsible for ensuring the accuracy of claims payment through the management of a robust process for prevention, detection, and correction of billing, payment and membership errors. Works with health plan leaders, oversees the monitoring and enforcement of the fraud, waste, and abuse compliance program to prevent and detect potential fraud, waste, and abuse activities pursuant to state and federal rules and regulations.

How you will make an impact:

Coordinate and respond to inquiries from executives, ensuring timely and accurate communication.
Handle the processing and management of Payment Integrity waivers.
Assist in preparing responses to Requests for Proposals across all lines of business.
Document process flows accurately to ensure clear and effective communication of processes.
Help with preparing presentations, ensuring they are polished and ready for delivery.
Review and approve performance guarantees, ensuring compliance with standards.
Has detailed technical knowledge of claims payment accuracy and participates on cross functional teams focused on problem remediation and long-term resolution.
Anticipates the effect of changes in the business environment on future claim errors.
Evaluates regulatory compliance and Health Care Reform changes to determine potential impact.
Evaluates provider activities to assist in the detection of fraud, waste and abuse activities.
Monitors provisions of the compliance plan, including fraud, waste, and abuse policies and procedures, investigates unusual incidents and implements corrective action plans.
Develops and analyzes monthly reports.
Develops project plans and oversees project execution, issue management and progress reporting.
Develops processes to support early detection of systemic issues causing operational inefficiencies.

Minimum Requirements:

Requires a BA/BS in business, engineering, nursing, finance, or healthcare administration and minimum of 5 years related work experience, including minimum of 2 years leadership experience; or any combination of education and experience, which would provide and equivalent background.

Preferred Skills, Capabilities, and Experiences:

2-5 years of experience with Fraud, Waste and Abuse.
Experience with payment integrity.
Familiarity with claims systems and processes.
Experience with GBD Facets.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

claims processing jobs in overland park, ks

Carelon Payment Integrity Manager - Kansas

HR Generalist

Claims Intake Administrator

Benefit Authorizer (Central Processing) Direct Hire Authority

Reimbursement Coordinator - Home Health

Operations Processor - Debit Fraud Case Processing

Patient Billing Representative

Workers’ Compensation Medical Only Claim Representative

RCM Specialist

CUSTOMER SERVICE REP

Patient Financial Advisor

Patient Accounting Rep II -- Customer Service

Specialty Billing Technician

Credit Dispute Specialist - Fidelity

Medicaid Billing & Compliance Specialist (KCK, Topeka, Wichita)

Benefit Authorizer (Central Processing) Direct Hire Authority

Field Service Representative I - Lenexa, KS

Risk Claims Manager

File Processing Admin

MEDICAL CLAIMS ADJUSTER

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