Claims Operations & QA Specialist

Blue Shield of CA; Springfield Meadows (CA); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Blue Shield of CA is seeking an Operations Specialist to support claims teams by performing end-to-end testing to identify defects in new code before it reaches production. You will create test cases that prevent or detect incorrect logic, downstream impacts, or output concerns affecting claim processing.

This hybrid role requires collaboration across multiple teams and the ability to work independently while upholding policies set by relevant state, federal, or local entities.

Qualifications

• Knowledge of healthcare claims processing required.
• Experience with user acceptance testing preferred.
• Familiarity with Agile methodology and Jira.
• Ability to work independently with strong prioritization and problem-solving skills.

Responsibilities

• Perform end-to-end testing to identify defects in new production code.
• Create test cases to prevent or detect incorrect logic and downstream impacts.
• Collaborate with cross-functional teams to develop efficient solutions in compliance with regulations.

Skills

Healthcare claims knowledge

End-to-end testing

Test case creation

Independent work

Prioritization

Critical thinking

Education

Bachelor's degree or higher

Tools

Jira

Job description

Blue Shield of CA is seeking an Operations Specialist to support claims teams by performing end-to-end testing to identify defects in new code before it reaches production. You will create test cases that prevent or detect incorrect logic, downstream impacts, or output concerns affecting claim processing.

This hybrid role requires collaboration across multiple teams and the ability to work independently while upholding policies set by relevant state, federal, or local entities.