Blue Cross and Blue Shield Association logo

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

Blue Cross and Blue Shield Association
  • Wilmington, DE
    14 days ago

    Job Description

    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 mission to 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 opportunity to achieve their full potential. We put these principles into action every day by 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 clients as 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.

    Numbers & Facts

    LocationWilmington, DE
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://www.bcbs.com/about-us/careers

    About Company

    At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

    Skills

    • Analysis Skillsunmatched
    • Communication Skillsunmatched
    • Cross-Functionalunmatched
    • Establish Prioritiesunmatched
    • Follow Throughunmatched
    • Healthcareunmatched
    • High School Diplomaunmatched
    • Identify Issuesunmatched
    • Microsoft Officeunmatched
    • Operational Improvementunmatched
    • Organizational Skillsunmatched
    • Problem Solving Skillsunmatched
    • Process Improvementunmatched
    • Root Cause Analysisunmatched
    • SQL (Structured Query Language)unmatched
    • Team Playerunmatched
    • Time Managementunmatched
    • Trend Analysisunmatched

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