Healthcare Claims Testing & Operations Specialist

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

Benefits offered by this job

Hybrid work model

Job summary

Blue Shield of CA is seeking an Operations Specialist to support claims testing and end-to-end verification of new production code. You will design test cases to catch logic errors and downstream processing issues while collaborating with multiple teams to improve efficiency and ensure compliance with applicable policies.

The role emphasizes independent work, critical thinking, and strong prioritization skills within a hybrid, in-office model.

Qualifications

• Bachelor's degree or equivalent with 4 years of relevant experience.
• Understanding of healthcare claims processing.
• Experience with user acceptance testing preferred.
• Knowledge of Agile methodology, including Jira preferred.
• Ability to work independently.
• Requires critical thinking and problem solving.
• Strong prioritization skills.

Responsibilities

• Support claims operational teams by performing end-to-end testing of new code.
• Create test cases to prevent or identify incorrect logic and downstream impacts.
• Collaborate with teams to develop solutions that improve efficiency and comply with regulations.

Skills

Healthcare claims processing

User acceptance testing

Agile / Jira

Independent work

Critical thinking

Prioritization

Education

Bachelor's degree / 4 years experience

Job description

Blue Shield of CA is seeking an Operations Specialist to support claims testing and end-to-end verification of new production code. You will design test cases to catch logic errors and downstream processing issues while collaborating with multiple teams to improve efficiency and ensure compliance with applicable policies.

The role emphasizes independent work, critical thinking, and strong prioritization skills within a hybrid, in-office model.