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Operational Quality Services Specialist, Associate

Blue Shield of CA

Your Role

The Medi-Cal Operations team is responsible for ensuring claims are processed accurately and in a timely manner. The Operational Quality Services Specialist, Associate will report to the Medi-Cal Operations Senior Manager of direct manager. In this role you will be responsible for performing audits that are routine in nature for the Medi-Cal line of business for all claim types.

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.

Your Knowledge and Experience

  • Requires a college degree or equivalent experience
  • Requires relevant experience
  • Prior auditing experience preferred
  • Minimum 1 or more years previous claims processing experience of all claim types
  • Knowledge of DHCS guidelines

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

Vacancy posted 4 days ago
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