Blue Cross Blue Shield Work From Home Jobs

The ITS Home Claims Processing team processes claims for our Blue Shield of California members for services preformed outside of California. The claims processor will report to the ITS Home Claims Supervisor.

In this role you will be responsible for processing claims for all lines of business and our claims are monitored by the Blue Cross Blue Shield Association to ensure accuracy across our plans.

Your Work

In this role, you will:

• Be experienced in back-end processing; proficient in resolving complex edits using available documents/job aids with minimum direction
• Experience front-end processing and difficult adjustments
• Be given special processing assignments; coordinate with other departments for resolution if needed
• Understand fundamentals of end-to-end (life of a clam) claims processing
• Perform established performance metrics

• Requires a high school diploma or GED
• Requires at least 3 years of experience
• Claims processing knowledge recommended but not required
• Requires good communication skills both written and verbally
• Requires the ability to make and receive phone calls both internally and externally while providing excellent customer service.
• Ability to adhere to a schedule based on the business needs.