Claims Edit Coder Jobs in Rosemount, MN (NOW HIRING)

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

As a Senior Business Analyst, you will work on Optum CES (Claims Edit System) and be responsible for the analysis, development, support, reporting and coordination of business workflow automation, and to implement efficient business processes at an enterprise level for Payment Integrity coding configuration.

• Conduct in-depth research and analysis, identify trends, emerging issues and recommend best practices to ensure maximum results, and develop metrics.
• Document metrics and process changes.
• Effectively analyze, design, develop, test, debug, implement, maintain and/or enhance new or existing systems through reporting and documentation.
• Participate in and coordinate individual projects and related activities to ensure project progresses on schedule.
• Maintain adequate communication regarding project status, risks, issues, and priorities with project sponsors and leadership.
• Act as a liaison with internal partners and external partners to identify opportunities and needs and research/develop implementation plans for meeting these needs.
• Represent the customer and/or stakeholder (internal/external) while collaborating with business and technical units.
• Serve as senior subject matter expert associated with content, processes, and procedures.
• Lead project teams and provide training to lower level staff to achieve project milestones and objectives.
• Perform additional responsibilities consistent with the scope and level of the role, as assigned.

• 5+ years of related information technology professional experience.
• Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

• Optum CES (Claims Edit System) experience.
• 5+ years of medical coding experience in lieu of Information Technology experience.
• FACETS platform experience.
• Ability to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, and align others to drive informed decisions.
• Ability to analyze complex information, evaluate options, and work cross-functionally to drive resolution and prevent recurrence.
• Ability to effectively organize work, balance competing priorities, and manage time across complex assignments and competing deadlines.
• Proficiency with business technology platforms, systems, software, and tools.
• Understanding of business operations, processes, or domain context.
• Ability to analyze information and support business decisions, solutions, or process outcomes.

Hybrid. Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite is full-time onsite. Our hybrid approach is designed to balance flexibility with meaningful in‑person connection and collaboration.

$90,800.00 - $120,300.00 - $149,800.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include medical, dental, and vision insurance, life insurance, 401(k), paid time off (PTO), volunteer paid time off (VPTO), and more.

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross and Blue Shield of Minnesota is an Equal Opportunity Employer and maintains an affirmative action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at talent.acquisition@bluecrossmn.com. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association. Chartered in 1933 as Minnesota’s first health plan, this company is one of the most recognized and trusted healthcare brands in the world. It has more members, the largest network of doctors, and more products and services than any other health plan in Minnesota. Headquartered in Eagan, Minnesota.