BlueCard Business Analyst

Business Analyst – BlueCard Claims OperationsWe are seeking a highly analytical and collaborative Business Analyst to support BlueCard daily operations and strategic initiatives within a fast-paced healthcare claims environment. This individual will play a critical role in resolving operational challenges, improving claims processes, and supporting a major HealthRules migration project impacting BlueCard operations.The ideal candidate will bring deep end-to-end BlueCard knowledge, hands-on experience with the BlueSquared BCBSA application, and a strong understanding of healthcare claims processing workflows within a Blue Plan environment. This is a high-visibility role supporting large-scale initiatives with tight turnaround times, requiring someone who is proactive, curious, detail-oriented, and comfortable working closely with cross-functional teams.This team is long-standing and highly collaborative, looking for someone who is willing to jump in where needed, ask questions, solve problems, and contribute to both daily operational support and future-state process improvements.Key ResponsibilitiesSupport BlueCard claims operations through detailed analysis of claim issues, inquiries, and processing discrepanciesPerform root cause analysis on incorrectly processed claims, failed DF/RFs, and operational defects while coordinating resolution efforts across teamsPartner with Configuration, Account Management, IT, and Operations teams to improve claims processing accuracy and member experienceCommunicate and collaborate with other Blue Plans through the BlueSquared BCBSA application (RTM)Support the HealthRules migration project and other enterprise initiatives impacting BlueCard operationsEvaluate current business processes and identify opportunities for workflow optimization, automation, and operational efficienciesUtilize data, reporting tools, bots, and technologies to drive continuous process improvement initiativesAssist with data extraction, reporting, documentation, testing, and maintenance of operational procedures and workflowsParticipate in User Acceptance Testing (UAT), system validation, and implementation support for enhancements and process changesServe as a subject matter expert (SME) for BlueCard operational processes in meetings, projects, and cross-functional initiativesShare process improvement ideas and operational best practices across the team to promote continuous improvement and collaborationRequired Qualifications3+ years of experience in medical claims processing, healthcare operations, claims adjudication, or healthcare administrationStrong end-to-end understanding of BlueCard operations and workflows within a Blue Plan environmentHands-on experience with the BlueSquared BCBSA application is requiredStrong understanding of healthcare claims processing, including ICD-10, CPT, HCPCS, and claims adjudication processesExperience performing root cause analysis and resolving claims processing discrepanciesWorking experience with SQL and Microsoft AccessAdvanced Microsoft Office skills, including Excel, Word, and PowerPointAbility to analyze and summarize large data sets and identify operational trends or inefficienciesStrong communication skills with the ability to work effectively across business and technical teamsProven ability to work independently in a fast-paced environment with competing priorities and tight deadlinesStrong attention to detail, critical thinking, and problem-solving skillsMust possess a curious mindset and willingness to ask questions and learn from team membersPreferred QualificationsTableau experienceExperience supporting HealthRules or claims platform migration initiativesExposure to automation tools, bots, or workflow optimization technologiesExperience participating in process improvement or operational transformation initiatives within healthcare claims operations