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RRT Anthem Analyst
The RRT Anthem Analyst will be responsible for handling all communications, adjustments, and closing out claims through various applications with our outside vendors, Blue Cross Blue Shield and Anthem.
ESSENTIAL FUNCTIONS:
* Review daily production reports and adjustment reports from Anthem to ensure claims and adjustments are closed within the designated turnaround time...

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE
Performs pricing and transparency reporting functions to ensure adherence to...

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE
The Medical Management Outpatient Pre-Auth Specialist provides administr...

At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.
Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there's no greater time for forward-thinking professionals like you...

At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.
Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there's no greater time for forward-thinking professionals like you...

At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.
Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there's no greater time for forward-thinking professionals like you...

Blue Cross and Blue Shield of Kansas is looking to add to our Medical Economics team and has a new opportunity for a Provider Analyst. We are seeking a detail-oriented and analytical Analyst with a focus on supporting data analysis, statistical modeling, and healthcare financial management tasks. This role involves assisting in analyzing financial and operational data to identify trends, suppor...

Blue Cross and Blue Shield of Kansas is looking to add to our Actuarial Pricing team and has a new opportunity for an Associate Actuary. This is a key role responsible for connecting deep Medicare expertise with actuarial principles relating to health plan risk and pricing. This position is a senior member of the team responsible for providing detailed forecasts, conducting and tracking profita...

Job Description
The County Engagement team at Blue Cross and Blue Shield of North Carolina (Blue Cross NC) works to develop local relationships and a comprehensive understanding of all 100 North Carolina counties to provide the best service and support to agencies, organizations, and individuals.
The Sr. Regional Liaison will focus on a specific group of counties, developing and maintaining re...

Accounting Specialist
Credit card reconciliation, billing, and general bookkeeping in a collaborative fast-paced environment.
* Up to 2 Days Remote (after 120-day training period)
* $23.00 - $26.00 Starting Base Pay
* Great growth opportunities within the team and company
* The Company pays for 100% of your and your dependent's Medical, Dental, and Vision Insurance! Blue Cross B...

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.
This position is remote/h...

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE
The ACO Clinical Documentation Lead is responsible for assessing and im...

Want to help make the world a safer, more sustainable and more creative place? It may sound like a lofty goal, but that’s exactly what we’re doing at Black Spectacles. Our platform attracts architects around the world who want to push the limits of their industry. Our content — which includes podcasts, design tutorials and exam prep — helps architects keep pace with emerging technologies and so...

Data Entry Specialist
Are you looking for a quiet, casual work environment? Do you have strong attention to detail and a can-do attitude? If so, this may be the job for you!
As a technology leader in healthcare process automation and interoperability, Smart Data Solutions (SDS) is a strategic partner that utilizes data and intelligent automation to digitally transform operations and deliver ou...

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware
Job Summary:
Responsible for conducting research and root cause analysis for customers with the goal of recommending and implementing new processes and solutions to operational deficiencies. Resolves issues and improves operational performance on a cross-functional/departmental basis. This is a sen...

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware
Job Summary:
Responsible for conducting research and root cause analysis for customers with the goal of recommending and implementing new processes and solutions to operational deficiencies. Resolves issues and improves operational performance on a cross-functional/departmental basis. This is a s...

Job Description
The AVP Special Investigations Unit (SIU) is responsible for overseeing and managing fraud, waste, and abuse (FWA) detection, investigation, and prevention efforts to safeguard the organization’s assets and reduce healthcare costs. This requires demonstrating vision in positioning the SIU with the right skill sets, cutting edge analytics tools, and robust processes to identify ...