Operations Processor Intermediate

Transformation is the opportunity

Blue Shield of California is the third largest health plan in California, with about $7.5 billion in revenue. Our mission is to ensure Californian's access to high-quality health care at a reasonable price.

Join Blue Shield of California and grow your career with a leader that’s stirring up a change.


Helping make health care for Californians easy, accessible and reasonably pricedis a great calling. Knowing that your company has channeled over $100 millionback into California communities and will continue to do so is flat outuplifting. Join the hardest working, not-for-profit health plan in Californiaand be part of the solution.

This position processes health plan related data and information using automatedsystems within established production and quality standards.

Makes decisions based on review of source documents for routine and difficultprocessing issues.

Looks up correct codes and enters data into system.

Researches information as appropriate to resolve problem encounters or claimsnot accepted by systems edits.

Contacts other internal staff to verify information and contacts physicians, andIPA providers for additional information as needed to complete processing work.

Prepares necessary case documents for further medical review.

Works under minimal supervision and responsible for assignments that range fromroutine to moderately complex.

Makes recommendations to management for improvements in work processes.

High school diploma or GED and two years related experience and/or training, orequivalent combination of education and experience.

Ability to enter and retrieve data using standardized keyboard functions.

Ability to read and interpret technical procedures or government regulations.

Ability to write basic correspondence and perform basic or complex arithmetic.

Specialized claims or membership processing training or experience. Knowledge ofmedical terminology.

Blue Shield of Califonia is an Equal Opportunity Employer.


Our comprehensive benefits begin on your first day with medical, dental and vision coverage; 20 days PTO annually; 9 paid holidays; matching 401(k); and company pension.

Blue Shield of California is an Equal Opportunity Employer.

An Independent Member of the Blue Shield Association.

Blue Shield of California

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