Operations Specialist- (Hybrid: PA, DE, NJ)

Independence Blue Cross; Philadelphia (Philadelphia County); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Independence Blue Cross is seeking an Operations Specialist for a hybrid role serving PA, DE, NJ. The position emphasizes managing daily caseloads, analyzing case details, and driving timely resolutions while collaborating with cross-functional teams.

The ideal candidate will have strong time management, organizational, and communication skills, with the ability to learn proprietary systems and use Excel/SQL for data analysis. A flexible, adaptable approach and professionalism are essential.

Qualifications

• High School Diploma required; Bachelor’s degree in Business or related field preferred
• Excellent time management and organizational skills required
• Ability to prioritize workload and meet deadlines in a fast-paced environment with minimal supervision
• Flexibility and adaptability are a must
• Willingness to be cross trained to assist other team members
• May support other team members with less complex cases
• Strong communications skills; interacts with management and external clients
• Must be a strong problem-solver and follow-up to resolution
• Strong understanding of accumulator benefits
• Strong critical thinking; understand accumulator/data feeds and apply them
• High level technical aptitude; use Microsoft Office and learn vendor systems
• High level of professionalism to progress

Responsibilities

• Manage and prioritize a daily caseload to ensure cases are resolved accurately and on time
• Investigate and analyze case details, identify root causes, and determine resolutions
• Collaborate with cross-functional teams to drive timely case outcomes
• Identify trends and recommend process improvements to enhance operations
• Provide regular status updates on open cases and assigned work
• Support team training and knowledge sharing
• Use SQL reports and Excel data extracts for diagnosis and resolution

Skills

Time management

Organizational skills

Prioritization

Communication skills

Problem solving

Technical aptitude

Professionalism

Education

High school diploma

Bachelor’s degree in business or related field

Tools

Microsoft Office

SQL Reports

Vendor systems

Excel

Job description

Operations Specialist- (Hybrid: PA, DE, NJ)

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our missionto enhance the health and well-being of the people and communities we serve.

At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunityto achieve their full potential. We put these principles into action every dayby acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace.Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

Operations Specialist is responsible for:

• Manage and prioritize a daily caseload to ensure cases are resolved accurately, efficiently, and within required compliance timeframes
• Investigate and analyze case details, identify root causes, and determine effective resolutions
• Collaborate with cross-functional teams to drive timely and accurate case outcomes
• Identify trends and recommend process improvements to enhance operational performance
• Provide regular status updates on open cases and assigned work
• Support team training and knowledge sharing
• Use SQL Reports and Excel Data extracts to diagnose and resolve issues
  Perform additional duties as assigned

Qualifications

• High School Diploma required, Bachelor’s degree in Business or related field preferred.
• Excellent time management and organizational skills required.
• Ability to prioritize workload and meet deadlines in a fast-paced environment with minimal supervision.
• Flexibility and adaptability are a must.
• Willingness to be cross trained is required to assist other team members.
• May support other team members with less complex cases.
• Strong communications skills required – position interacts with various levels of management and may communicate with external clientsas well.
• Must be strong problem-solver and be able to follow-up and take an issue to resolution.
• Strong understanding of accumulator benefits.
• Strong critical thinking skills; Capability to understand accumulator/data feeds and apply them.
• High level technical aptitude required - ability to use Microsoft Office and to learn proprietary and vendor systems.
• High level of professionalism is necessary to progress.

Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Inclusion and Belonging

At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com . We’re revolutionizing health care, and our focus is on you!

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Agency Disclaimer

All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.