Analyst - Payment Integrity Prospective Editing

Blue Cross Blue Shield • Detroit, MI

376d

About The Position

The Analyst - Payment Integrity Prospective Editing role at Blue Cross Blue Shield of Michigan involves supporting management in evaluating and improving production workflows and operational processes. The position focuses on enhancing customer service levels and overall quality through project coordination, operational data analysis, and effective communication of policy changes.

Requirements

• Bachelor's Degree in a related field is preferred.
• Two (2) years of experience in a related field is required.
• Effective verbal, written communication and interpersonal skills.
• Ability to work independently or in a team environment and interact with all levels of the organization.
• Effective analytical and problem-solving skills to identify and implement changes.
• Organizational skills and ability to prioritize multiple activities.
• Proficient in Microsoft Office suites.
• Ability to develop and maintain effective working relationships.

Nice To Haves

• Experience with coding credentials such as CPC, RHIT or CCS is preferred.

Responsibilities

• Assist and support management in evaluating and recommending new workflows and processes.
• Compile and analyze operational data to identify and resolve business problems.
• Utilize and maintain reporting systems and participate in systems testing.
• Develop procedures and controls, providing recommendations for process improvements.
• Provide status updates on projects and issues to the leadership team.
• Communicate and recommend policy changes to achieve project objectives.
• Document departmental procedures and create reports to display operational data.
• Support internal departments and external entities by answering questions and providing training.
• Participate in special projects or workgroups as assigned.

What This Job Offers

• Job Type: Full-time
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree