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Operations Specialist Intermediate (Claims Admin Research Team) Job
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| Employer Name: |
SpiderID: 13751948 |
| Location: El Dorado Hills, California |
Date Posted: 5/22/2024 |
| Wage: Negotiable |
Category: Insurance |
| Job Code: 17002DC-2191 |
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Job Description:
 Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California's Mission is to ensure all Californians have access to high-quality care at an affordable price. Blue Shield is focused on improving health care delivery by working closely with providers and making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 4 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.
We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.
Description:
Responsible for being the subject matter expert on functional operational workflows, databases, systems and applications, procedures, tools and documentation, for the purpose of enhancing operating efficiency, quality, and technical skill levels of staff. Acts as subject matter expert and reviews operational workflows, identifying problems and develops improvements, modifications, and enhancements. May maintain databases required for business operations. Reviews systems and applications and recommends system edits/changes as needed. Develops and evaluates tools and materials that enhance operating efficiency, accuracy and technical skill levels of unit staff. Tracks and communicates workflow and system changes to appropriate resources . May assist with training and documentation needs. Develops and generates reports for management review. Notifies appropriate department mangers about issues and problems in operational workflow requiring immediate attention. Participates as a subject matter expert in the development of written guidelines and documents problems as needed.
Qualifications:
Education/Requirements: Broad range of administrative and/or technical skills. Develops analytical capacity through the study of concepts and methods. Knowledge of automated systems in a production or operations environment. Ability to identify and resolve moderately complex problems related to automated systems and operations within the functional area. Strong communication skills. Good problem-solving skills. Three to five (3 - 5) years related experience and/or training, or equivalent combination of education and experience. At least two (2) years experience in a claims, customer service, installation/membership or member services role in the health care industry
Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:
Contact Information:
| Contact Name: Blue Shield of California |
Company Type: |
| Company: Blue Shield of California |
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