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Claims Process Analyst

Company: Blue Cross Blue Shield of Michigan
Location: Grand Rapids
Posted on: May 23, 2020

Job Description:

Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality.


  • Support the development, coordination, and implementation of projects to enhance the overall efficiency of operational procedures, methods, controls, and performance.
  • Compile and analyze operational data to identify and resolve business problems.
  • Utilize and maintain available reporting systems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
  • Provide leadership team with status updates on projects and issues.
  • Communicate and recommend policy changes to achieve project objectives. Assist in documenting departmental procedures.

  • Create and present reports and presentations to display operational data and propose business changes.

  • Provide support to both internal departments and external entities by answering questions, supplying information and training.
  • Participate on special projects or workgroups as assigned.


    • Bachelor's Degree in a related field is preferred.
    • Two (2) years of experience in a related field is required.
    • Effective verbal, written communication and interpersonal skills.
    • Ability to work independently or in a team environment and interact with all levels of the organization.
    • Effective analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
    • Organizational skills and ability to prioritize; must be able to coordinate multiple activities with varying timelines.
    • Proficient in Microsoft Office suites.
    • Ability to develop and maintain effective working relationships.


      Departmental requirements:

      • Two (2) to five (5) years' experience in health care environment, preferably in managed care.
      • One (1) year process improvement experience.
      • One (1) year project management experience preferred.
      • Proven experience in problem analysis, data analysis, root cause identification/document and problem resolution activities.
      • Demonstrated, proficient working knowledge and experience with Microsoft Suite (Excel, Access and Visio) required
      • Digital visualization tools (such as Power BI, Tableau) preferred
      • Health care Claims processing experience required
      • Working knowledge of Facets operational system and Macess highly preferred

        All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.

Keywords: Blue Cross Blue Shield of Michigan, Grand Rapids , Claims Process Analyst, Professions , Grand Rapids, Michigan

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