Healthcare Claims QA & Operations Specialist

Blue Shield of CA; San Diego (CA); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Blue Shield of CA is seeking an Operations Specialist to support claims teams by performing end-to-end testing and crafting test cases that identify defects and prevent processing issues.

The role reports to a manager and involves independent work as well as collaboration to develop efficient solutions in line with healthcare regulations. This is a hybrid position with in-office presence required on a regular basis.

Qualifications

• Healthcare claims processing knowledge required
• Experience with user acceptance testing preferred
• Familiarity with Agile methodologies and Jira is a plus

Responsibilities

• Perform end-to-end testing of new code to identify defects and ensure quality
• Create test cases to detect incorrect logic, downstream impacts, and output concerns
• Collaborate with cross-functional teams to improve efficiency in claims processing and adherence to policies

Skills

End-to-end testing

User acceptance testing

Agile methodologies

Jira

Independent work

Critical thinking

Prioritization

Education

Bachelor's degree or HS Diploma/GED with 4 years experience in lieu

Tools

Jira

Job description

Blue Shield of CA is seeking an Operations Specialist to support claims teams by performing end-to-end testing and crafting test cases that identify defects and prevent processing issues.

The role reports to a manager and involves independent work as well as collaboration to develop efficient solutions in line with healthcare regulations. This is a hybrid position with in-office presence required on a regular basis.