Healthcare Claims Operations & QA Specialist

Blue Shield of CA; Lodi (CA); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Blue Shield of California seeks an Operations Specialist to support claims teams by performing end-to-end testing of new code before it reaches production. You will create test cases to prevent incorrect logic and downstream impacts, ensuring accurate claim processing and outputs.

The role emphasizes independent work within a collaborative, cross-functional environment. Hybrid workplace model requires in-office presence two days per week; candidates should be ready to coordinate with managers to

Qualifications

• Bachelor's degree or HS diploma with 4 years of related experience in lieu of a degree.
• Understanding of healthcare claims processing required.
• User acceptance testing experience preferred.
• Knowledge of Agile methodologies and Jira preferred.
• Ability to work independently.
• Requires critical thinking and problem solving.
• Strong prioritization skills.

Responsibilities

• Perform end-to-end testing to identify defects in new code before production deployment.
• Create test cases to prevent or identify incorrect logic and downstream impacts.
• Collaborate with cross-functional teams to develop solutions that improve efficiency and accuracy.
• Support claims operations teams and report to the manager.

Skills

Independent work

Critical thinking

Prioritization

Team collaboration

Education

Bachelor’s degree or 4 years experience in lieu

Tools

Jira

Job description

Blue Shield of California seeks an Operations Specialist to support claims teams by performing end-to-end testing of new code before it reaches production. You will create test cases to prevent incorrect logic and downstream impacts, ensuring accurate claim processing and outputs.

The role emphasizes independent work within a collaborative, cross-functional environment. Hybrid workplace model requires in-office presence two days per week; candidates should be ready to coordinate with managers to