Manager - BCBSA Requirements and Reporting

If you are interested in joining a growing enterprise, we welcome you to consider a career as a Manager - BCBSA Requirements and Reporting with Blue Cross of Northeastern Pennsylvania. Since 1938, Blue Cross has proven to be a vital health partner in northeastern and north central Pennsylvania. For consideration, qualified applicants should apply to www.bcnepa.com, refer to Job #R0146.

 

The Manager, BCBSA Requirements and Reporting, has three primary responsibilities:To interpret, analyze and provide guidance and direction for all new and modified BCBSA requirements that affect claims processing and the benefits inquiry database. This position will interact closely with the Blue Card Executive to ensure that the Claims Department receives timely notification of BCBSA requirements and is in full compliance with those requirements. This role will also work with the IT department to oversee any system modifications that may be required to assure compliance with BCBSA requirements. To ensure adequate and appropriate staffing levels in the Claims Dept. by providing timely accurate data, data analysis, process recommendations and real-time business operations status feedback relative to claims quality, productivity, work flow volumes, auto adjudication, etc. To assist Claims Management in budget preparation and analysis.

   

Requirements include a Bachelor's Degree in Business Administration or Healthcare Administration and four to six years experience including management experience, project manager experience, consultant or other analytical/ problem solving experience. Professional experience, acquired knowledge and training must have been in a service delivery environment, preferably within the health insurance industry. Management experience should be progressively responsible with a proven record of exemplary customer service delivery. Experience should demonstrate track record of results that required innovative thinking, which translated into practical business approaches; and successfully developing and managing an operation budget. A working knowledge of process redesign, financial management, reimbursement systems, and computer systems is required.

 

At Blue Cross you will receive outstanding opportunities to grow and develop, as well as exceptional benefits to live a healthy life. Blue Cross of Northeastern Pennsylvania employees enjoy a competitive benefits package with core benefits including medical, dental, and vision insurance; 401k retirement plan; tuition reimbursement; paid time off including vacation, sick, and personal time; and life insurance. Additional information and the complete listing of available career opportunities are available on www.bcnepa.com