Claims Manager

Important Recruitment Information for this vacancy

Job Posting closes: May 01, 2025

Required documents uploaded by: May 01, 2025

Kansas Department of Health and Environment:

Our agency is led by Secretary Janet Stanek, who was appointed by Gov. Kelly in Dec 2021. KDHE is comprised of three divisions: Public Health, Environment, and Health Care Finance (which includes the State’s Medicaid program, KanCare). We are the only agency in the nation to have these three entities under one roof which allows us to take a holistic approach to improving and protecting the health and well-being of all Kansans.

About the Position

Who can apply: External (Open to Anyone)

Classified/Unclassified Service: Unclassified

Full-Time/Part-Time: Full-time

Regular/Temporary: Regular

Work Schedule: Monday-Friday, 8am-5pm (Flexible schedules available)

Eligible to Receive Benefits: Yes

Veterans' Preference Eligible: Yes

Compensation:

• Hourly Pay Range: $21.13-$23.87
• Salary can vary depending upon education, experience, or qualifications.

Employment Benefits

Comprehensive medical, mental, dental, vision, and additional coverage

Sick & Vacation leave

Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave

Paid State Holidays (designated by the Governor annually)

Fitness Centers in select locations

Employee discounts with the STAR Program

Retirement and deferred compensation programs

Visit the Employee Benefits page for more information…

Position Summary & Responsibilities

Position Summary:

The position (K0239431)

Claims and Encounter Data Projects:

Review all project related documents. Review, provide input, works with sister agencies, make decisions regarding changes and design specifications that would affect claims and encounter data processing. Attend and participate in all projects related meetings.

Job Responsibilities may include but are not limited to the following:

Managed Care – Claims and Encounter Data Management, Oversight and Compliance Monitoring. Provide guidance and direction on the submission of claims and encounter data processing by performing the following:

Provide guidance and direction on the submission of claims and encounter data processing between contractors. Perform reviews of managed Care claims and encounter data activities to ensure that all contract (state and federal) requirements are met. Track and manage all findings and observations resulting from the review. Review reports to ensure claims and encounter data is valid, accurate, complete, and submitted timely and in compliance with state and federal regulations. Attend, participate in or facilitate various meeting involving claims processing or encounter data. Review publications and contracts as necessary. Work with the contractors on remediation or corrective action plans when necessary. Review processes to ensure they are in compliance with their contract, including but not limited to Front End Billing. Direct the activities related to the management of the claims, corrected claims, claims reprocessing and encounter claims inventory. Work with KDHE, sister agencies or KDHE contractors in monitoring contractors.

Qualifications

• Education:
  • High School, GED
• Licensing & Certification:
  • Valid Driver's License - Incumbent is required to have and maintain a valid driver's license when operating a state vehicle, a private vehicle, or a rental vehicle for the benefit of the State
• Minimum Qualifications:
  • Minimum Requirements (MR) as stated in the State of Kansas Specification. Note: Do not include substitution statement indicated on class specification. However, if substitution is desired, specifically describe substitution. Candidate must be located within 1 hour travel from Topeka, KS
  • Word, Excel, PowerPoint, Access
  • Proofreading, editing, attention to detail
  • Ability to gather relevant information and ability to provide concise and accurate reports
  • Ability to analyze statutes and regulations
  • One year Customer Service experience
• Preferred Qualifications:
  • Bachelor’s Degree – Any field of study
  • General knowledge of federal and state laws and regulations regarding health insurance claims
  • Ability to interpret and apply policies affecting agency program operations
  • Ability to conduct formal presentations or negotiate and persuade to settle issues
  • Analytical and organizational skills

Recruiter Contact Information

Name: Tracey Benson

Email: Tracey.N.Benson@ks.gov

Mailing Address: 1000 SW Jackson St. Suite 580 Topeka, KS 66612

Job Application Process

• First Sign in or register as a New User.
• Complete or update your contact information on the Careers> My Contact Information page. *This information is included on all your job applications.
• Upload required documents listed below for the Careers> My Job Applications page. *This information is included on all your job applications.
• Start your draft job application, upload other required documents, and Submit when it is complete.
  • Manage your draft and submitted applications on the Careers> My Job Applications page.
• Check your email and My Job Notifications for written communications from the Recruiter.
  • Email – sent to the Preferred email on the My Contact Information page
  • Notifications – view the Careers> My Job Notifications page

Helpful Resources at jobs.ks.gov: “How to Apply for a Job – Instructions” and “How to Search for a Job – Instructions"

Required Documents for this Application to be Complete

Upload these on the Careers - My Job Applications page

Transcripts

DD214 (if you are claiming Veteran’s Preference)

Upload these on the Attachments step in your Job Application

• Resume
• Cover Letter

Helpful Resources at jobs.ks.gov: “How, What, & Where do I Upload Documents”

How to Claim Veterans Preference

Veterans' Preference Eligible (VPE): Former military personnel or their spouse that have been verified as a "veteran"; under K.S.A. 73-201 will receive an interview if they meet the minimum competency factors of the position. The veterans' preference laws do not guarantee the veteran a job. Positions are filled with the best qualified candidate as determine by the hiring manager.

Learn more about claiming Veteran’s Preference

How to Claim Disability Hiring Preference

Applicants that have physical, cognitive and/or mental disabilities may claim an employment preference when applying for positions. If they are qualified to meet the performance standards of the position, with or without a reasonable accommodation, they will receive an interview for the position. The preference does not guarantee an applicant the job, as positions are filled with the best qualified candidate as determined by the hiring manager.

Learn more about claiming Disability Hiring Preference

PLEASE NOTE: The documentation verifying a person's eligibility for use of this preference should not be sent along with other application materials to the hiring agency but should be sent directly to OPS. These documents should be sent either by fax to (785)296-7712, scanned and emailed to Gustavo.Victoriano@ks.gov, or can be mailed/delivered in person to:

ATTN: Disability Hiring Preference Coordinator
Office of Personnel Services
Landon State Office Building
900 SW Jackson, Rm 401
Topeka, KS 66612

Equal Employment Opportunity

The State of Kansas is an Equal Opportunity Employer. We value diversity, equity, and inclusion as essential elements that create and foster a welcoming workplace. All qualified persons will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, political affiliation, disability or any other factor unrelated to the essential functions of the job.

If you wish to identify yourself as a qualified person with a disability under the Americans with Disabilities Act and would like to request an accommodation, please address the request to the agency recruiter.