Operations Specialist, Associate

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

Your Role

The Operations Specialist supports claims operational teams by performing end-to-end testing to identify defects of new code being introduced to the production environment. Creating test cases that will prevent or identify incorrect logic, claims downstream impacts, output concerns or other claim processing issues. The Operations Specialist will report to the manager. In this role, you will work both independently and collaborate within the team and other teams to develop solutions that will enhance and create efficiencies in accordance with policies and provisions set forth by state, federal or local entities.

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

• Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• Understanding of healthcare claims processing required
• Experience with user acceptance testing preferred
• Knowledge and experience of Agile methodology, including Jira preferred
• Ability to work independently
• Requires critical thinking and problem solving
• Strong prioritization skills

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.