Blue Cross Analyst Jobs (NOW HIRING)

Position Description

Base pay is influenced by several factors including a candidate's qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.   

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it's why our employees consistently vote us one of the "Best Places to Work in PA."  

This position provides analytical, technical and problem solving support to the Manager Large Group Delinquency. There are various systems involved including but not limited to: Facets, the RAP database, e-Payment systems, various SharePoint sites, etc. They collaborate with Legal, Operations, Sales, IT&D and other business areas to resolve delinquency issues and minimize business risk. The analyst understands the end-to-end process for group setup, payment and delinquency. This includes downstream impacts when system and process changes occurs as well as establishing, documenting and monitoring of payment plans that mitigate corporate risk. They complete assignments and projects using innovative approaches and solutions to business problems using their knowledge and experience. They provide analytical data and Large Group receivable reports to Finance management. They must have excellent communication skills, through written and verbal means.

Responsibilities and Qualifications

• Development and maintenance of Large Group delinquency processes. This includes automating as much of the process as is possible and developing ways to manage and report on the manual portions. This is a delicate process as the goal is to mitigate risk for the Company while maintaining a positive relationship with the customer.
• Analyze and report on complex receivable data. This includes working with staff to confirm the accuracy of internal reports. This also Includes but is not limited to variance analysis, development of reports, tracking tools and improve existing ones to analyze, project and record results. Other reports as required.
• Ability to serve as a department project lead for medium scale (40-500 hours) department/corporate projects and/or maintenance activities as assigned. Includes the ability to communicate project team status updates verbally and in writing to all team members. Ability to identify potential projects risks and contingencies. Consider root cause analysis and identify process improvement opportunities.
• Manage and monitor group payment arrangements as well as other delinquency issues of concerns. This includes working with Legal and other areas to prepare letters or other communications as necessary.
• Ability to summarize verbally and in writing advanced analytical research that is understandable to the intended audience. Ability to facilitate meetings including preparing agendas, minutes, and other documentation as needed. Communicate any roadblocks or impacts to both management and business areas.

Skills:

• Proven ability to direct and guide to successful completion, multiple, simultaneous, complex projects that have substantial/critical impacts on the customer/business.
• Ability to analyze problems and issues, determine impact, and develop business solutions for system changes. Ability to act as a liaison and recommend solutions to a variety of departments, as well as other Plans and other external business partners.
• Very strong analytical skills (both quantitative and qualitative); must possess the ability to move in and out of complex spreadsheets by quickly and independently understanding the purpose, results and conclusion of the analyses.
• Ability to plan, organize, lead and control projects. Includes the ability to effectively communicate in writing and verbally with technical and non-technical audiences. Also includes persuasion and negotiation skills to resolve differences with skill and understanding.
• Ability to analyze complex problems and issues, determine impact, and develop business solutions or recommendations for changes.
• Ability to communicate effectively with all levels of internal/external personnel and to prepare written materials and oral presentations for technical and non-technical audiences. Includes the ability to lead effective meetings and to conduct effective interviews with prospective employees. Ability to adapt to constantly changing priorities of multiple customers.
• Ability to lead meetings and give presentations to both management and staff. Includes the ability to develop teamwork among diverse groups.

Knowledge:

• Demonstrate detailed knowledge of the group invoicing/billing process within Facets as well the ASO invoicing on SharePoint.
• Knowledge of the health care industry and Capital corporate structure. Includes knowledge of standards, policies, and business practices and procedures for multiple departments/systems. Is familiar with those business services, systems and/or processes provided by external business partners.
• Adept at using Microsoft Office Suite of products.

Experience:

• 3 years' experience working with an integrated business system that handles claims processing, membership, billing, network, clinical, customer service, and product processes.
• Experience planning, organizing, and managing major activities. Ability to comply with all corporate and department policies, procedures and standards.

Education and Certifications:

• Bachelor's degree preferred

Physical Demands:

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
• The employee must be able to work over 40 hours per week.
• The employee must occasionally lift and/or move up to 5 pounds.

About UsWe recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community.  We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you'll help us live our mission of improving the health and well-being of our members and the communities in which they live.  Employment Type: FULL_TIME