Analyst - Senior (Claims)

Blue Cross Blue Shield of Michigan; Detroit (MI); Vor Ort; USD 70.000 - 100.000; Vollzeit

Zusammenfassung

Blue Cross Blue Shield of Michigan is seeking a detail-oriented professional to identify and analyze operational data, improve workflows, and lead projects across departments. The role emphasizes delivering actionable insights, optimizing processes, and communicating results to drive better customer service and cost efficiency.

The position requires a strong analytical mindset, proven project leadership, and excellent communication skills to influence decisions and collaborate with multiple

Qualifikationen

• Bachelor's Degree in a related field preferred.
• Four years of experience in a related field required.
• Strong analytical and problem-solving skills to identify and improve processes.
• Excellent verbal, written, and interpersonal communication skills.
• Ability to lead multiple projects with varying timelines.

Aufgaben

• Identify and analyze operational data to support business objectives.
• Develop and improve workflows and business processes to enhance customer service and reduce costs.
• Lead projects and teams to achieve desired results.
• Document and communicate project milestones and results.
• Create reports and presentations to display operational data and proposed changes.

Kenntnisse

Analytical skills

Problem solving

Leadership

Communication

Interpersonal skills

Project management

Organizational skills

Ausbildung

Bachelor's Degree in related field

Tools

Microsoft Office

Jobbeschreibung

Job Description

• Identify and analyze operational data and develop insights in support of business objectives.
• Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.
• Identify and/or analyze business problems and develop recommendations for solutions to problems.
• Lead the development and implementation of projects and/or teams in order to produce desired results.
• Document and communicate project concepts, milestones and results.
• Recommend and assist with implementing standard policies and procedures.
• Ensure that corporate compliance is communicated, implemented and monitored on an ongoing basis.
• Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
• Provide support to internal departments and external entities by answering questions, supplying information and training.
• Create and present reports and presentations to display operational data and proposed business changes.

Job Description

• Identify and analyze operational data and develop insights in support of business objectives.
• Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.
• Identify and/or analyze business problems and develop recommendations for solutions to problems.
• Lead the development and implementation of projects and/or teams in order to produce desired results.
• Document and communicate project concepts, milestones and results.
• Recommend and assist with implementing standard policies and procedures.
• Ensure that corporate compliance is communicated, implemented and monitored on an ongoing basis.
• Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.Provide support to internal departments and external entities by answering questions, supplying information and training.
• Create and present reports and presentations to display operational data and proposed business changes.

Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers.

Qualifications

• Bachelor's Degree in a related field is preferred.
• Four (4) years of experience in a related field is required.
• Excellent analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
• Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines.
• Excellent verbal, written communication and interpersonal skills.
• Ability to lead and contribute to business unit and/or corporate projects.
• Proficient in Microsoft Office Suites.
• Ability to develop and maintain effective working relationships.

Department Preferences

• Proven experience processing Facets BCNA claims across Facility, Professional, and Home lines of business.
• Understanding of Medicare Advantage plan structure and CMS regulations & guidance.

All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.