Capital Blue Cross

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.” We 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.

Performance Analyst

AnalystAnalystFull TimeRemoteTeam 1,001-5,000Since 1938H1B SponsorCompany SiteLinkedIn

Location

Pennsylvania

Posted

30 days ago

Salary

$47.8K - $91.1K / year

High School5 yrs expEnglish

Job Description

• Audits FEP claims, customer service inquiries, member and group enrollment activities in accordance with Plan Incentive Program (PIP) guidelines • Completing Performance Guarantee audits • Supports IA and SIU with assistance as needed • Utilizing internal formatting, maintains adequate documentation to support all audit reviews and outcomes • Providing this material to the appropriate Performance Analyst for internal and BCBSA report compilation • Participate in team collaborative efforts to resolve audit issues • Utilizes the internal SharePoint Audit tool to communicate findings and follow up assuring corrective action is taken and documented

Job Requirements

  • A minimum of 5 years' experience in Claims, Membership or Customer Service
  • Knowledge of FEP required
  • Audit and/or analytical experience required
  • Understanding of the healthcare industry as it relates to BCBSA
  • Understanding of claims coding and processing including BlueCard, ITS and FEP
  • Familiar with FEPDirect and Microsoft Office applications especially Excel
  • High School diploma or GED

Benefits

  • Medical, Dental & Vision coverage
  • Retirement Plan
  • Generous time off including Paid Time Off
  • Holidays
  • Volunteer time off
  • Incentive Plan
  • Tuition Reimbursement

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