2 years of experience in healthcare or insurance field with emphasis on Business Analysis including Healthcare EDI (levels 2 - 4)
2 years of experience in a role with demonstrated ability to communicate with diverse groups of people inside and outside of the business (levels 2 - 4)
2 years of experience triaging complex issues from member and/or providers or experience as a ICS Triage Analyst. (lev 1)
Required Education
High-School Diploma or GED in general field of study (All Levels)
Required Licenses
N/A
Required Certifications
Preferred Work Experience (All levels)
5 years of experience in healthcare or insurance field with an emphasis on Business Analysis including Healthcare EDI.
5 years of experience in a role with a demonstrated ability to communicate with diverse groups of people inside and outside the business
1 year testing experience
1 year of experience in project management
Preferred Education
Bachelor's Degree in Computer Science, Information Systems, Business, or related field (All levels)
Preferred Licenses
Preferred Certifications
Business Analyst Certification (All levels)
ESSENTIAL job functions AND RESPONSIBILITIES
Level 1
Write and review business requirements, flow specifications or change requests
Write test scripts, perform testing and post-production validation
Conduct research and analysis for issue resolution relating to electronic transactions, customer service applications, claim adjudication systems including reporting, process efficiencies. Track all items through to resolution.
Provide first or second level support for internal/external customers
Utilize problem-solving skills to improve procedures and processes, resolve system deficiencies and implement enhancements
Act as a liaison between external/internal customers and IT; communicate system and process changes to business areas
Level 2
Develop moderate complex (e.g. multiple departments/systems) business requirements on large projects and flow specifications with limited management direction.
Provide support to external customers to onboard Healthcare EDI processing and achieve HIPAA Transaction and Code Set compliance.
Provide subject matter expert (SME) advice related to electronic transactions and other corporate systems in the prioritization of workload or issue research.
Facilitate and/or create new operational procedures and processes resulting from advancing technologies or capabilities.
Lead small to medium size projects; act as UAT Coordinator including test strategy and plan development
Interpret design specifications for comparison against defined business needs to ensure compatibility, consistency and completeness
Resolve differences between customers and other team members in order to achieve organizational and project goals
Utilize existi
Benefits
Health insuranceRemote work options
Additional Information
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
Onsite: daily onsite requirement based on the essential functions of the job
Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building
Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.
Purpose of the job
On behalf of internal and external customers, gather and document business requirements, provide research and analysis related to project deliverables or production (break/fix) issues, conduct user acceptance testing (UAT), and act as a liaison between business customers, external customers, project teams and IT.
Bcbsaz · AZ Blue Phoenix, AZ 85021