Operations Specialist, Associate

Blue Shield of California • Rancho Cordova, CA

4d • Hybrid

About The Position

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.

Requirements

• 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
• Ability to work independently
• Requires critical thinking and problem solving
• Strong prioritization skills

Nice To Haves

• Experience with user acceptance testing preferred
• Knowledge and experience of Agile methodology, including Jira preferred

Responsibilities

• Perform end to end testing on service enhancements, projects, mandates, and strategic initiatives.
• Providing through testing on all requirements to ensure accuracy of requirements.
• Act as subject matter expert and review operational workflows, identifying problems and acting as a SME to inform improvements, modifications, and enhancements.
• Track and communicate workflow and system changes to appropriate resources.
• Review systems and applications and recommend system edits/changes as needed.
• Notify appropriate department managers about issues and problems in operational workflow requiring immediate attention.
• Participate as a subject matter expert to inform the development of written guidelines. and documents problems as needed.
• Research source material and evaluate process flows.
• Collaborate cross-functionally with internal and external teams.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree