Hybrid Claims Processing Specialist

Blue Shield of CA; Lodi (CA); Hybrid; USD 85,000 - 110,000; Full time

Job summary

Blue Shield of CA in California is seeking a Claims Processor, Specialist to join our hybrid team. You will ensure claims are processed accurately and timely and coordinate with other departments and vendors involved in the claims cycle.

The role reports to the Operations Manager and requires strong Excel/Office skills and a deep understanding of end-to-end health plan processing. Our leadership model develops leaders at all levels and supports personal, professional, and financial growth.

Qualifications

• High School Diploma or GED or 1 year of relevant experience.
• 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.

Responsibilities

• Process and ensure accurate, timely health claim processing.
• Interface with other departments and vendors involved in the claims process.
• Serve as the primary contact for priority claim cases.
• Collaborate with leadership to develop great leaders at all levels and foster continuous learning.

Skills

Excel

Outlook

PowerPoint

Word

Education

High School Diploma or GED

Job description

Blue Shield of CA in California is seeking a Claims Processor, Specialist to join our hybrid team. You will ensure claims are processed accurately and timely and coordinate with other departments and vendors involved in the claims cycle.

The role reports to the Operations Manager and requires strong Excel/Office skills and a deep understanding of end-to-end health plan processing. Our leadership model develops leaders at all levels and supports personal, professional, and financial growth.