Claims Processor, Specialist

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

Job summary

Blue Shield of CA is seeking a Claims Processor Specialist to ensure accurate and timely processing of claims. You will interface with multiple departments and vendors, and serve as the primary contact for priority claim cases.

The role reports to the Operations Manager and supports a leadership-driven culture with opportunities for growth. The position offers a hybrid virtual work arrangement, requiring in-office presence based on business need, with a focus on developing leaders across the

Qualifications

• High School Diploma or GED or 1 year of additional relevant experience in lieu of a diploma is required.
• 7 years of prior relevant experience is required.
• Thorough knowledge of advanced health plan processing operations and procedures within Claims Processing with a deep understanding of end-to-end claims processing fundamentals required.
• Advanced-Expert skills creating documents/files using Excel, Outlook, Power Point, and Word.

Responsibilities

• Interface with other departments and vendors involved in the Claims process.
• Serve as the primary point of contact for priority claim cases.
• Report to the Operations Manager.

Skills

Advanced health plan processing

Education

High School Diploma or GED or 1 year of experience in lieu of a diploma

Tools

Excel

Outlook

PowerPoint

Word

Job description

Your Role

The Claims operational teams are responsible for ensuring claims are processed accurately and timely. The Claims Processor, Specialist will report to the Operations Manager. In this role you will be responsible for interfacing with other departments and vendors involved in the Claims process and will also serve as the primary point of contact for priority claim cases.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• High School Diploma or GED or 1 year of additional relevant experience in lieu of a diploma required
• 7 years of prior relevant experience required
• Thorough knowledge of advanced health plan processing operations and procedures within Claims Processing with a deep understanding of end-to-end claims processing fundamentals required
• Advanced-Expert skills creating documents/files using Excel, Outlook, Power Point, and Word required

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.