Ready to help us transform healthcare? Bring your true colors to blue.

The Senior Claims Testing Analyst is responsible for reviewing business requirements,

developing, and executing comprehensive test plans, analysis of reporting, performing claims quality

review, mentoring associates and ensuring department goals are met in a high-quality manner within

established time frames

Key Accountabilities:

• Define, develop, and implement test plans and test cases to validate new coding logic or system changes for complex business requirements

• Work closely with IT on testing automation and consistent improvement opportunities for enhanced testing output

• Present test plans to internal partners

• Ensure identified compliance risks are reported to leadership when discovered

• Keen attention to detail and documentation with the ability to independently prioritize deliverables

• Support monthly team quality review and contribute to internal departmental process improvement opportunities

• Analyze and troubleshoot system issues, report defects, and develop recommendations for improvement

• Champion on-going assessments and analysis of test results, identify, and implement opportunities to improve the effectiveness of testing

• Lead special projects and assignments as identified by Leader

• Ensure internal Quality and Audit controls are followed including traceability of testing efforts

• Lead implementing of innovative initiatives to streamline processes, including automation possibilities.

• Develop and maintain technical documentation and user manuals as processes change.

• Participate in requirements walk-throughs and make recommendations that will satisfy Medicare Markets business processes

• Demonstrated flexibility and willingness to change, as the business needs change within the organization.

• Provide training & mentoring to junior associates

• Serve as a Medicare Advantage SME of the HealthEdge Source pricing platform

• Prepare and deliver communications, reports and supporting documentation to directors and managers related to project assignments.

Key Competencies:

• Excellent interpersonal, verbal, and written communication skills; able to effectively communicate to all levels of management

• Self-starter with demonstrated analytical skills and attention to detail

• Self-motivated individual with excellent organizational abilities and the flexibility to handle multiple priorities and meet aggressive deadlines

• Demonstrates action orientation, accountability and persevere through challenges to meet goals

• Collaborating toward shared goals, works with leaders to evaluate options by considering implications, risks, feasibility, and consequences

• Display commitment to teamwork

• Ability and drive to present change ideas across a broader partnership team, including customers and delivery partners

• Ability to drive collaboration across the business to get things done.

Experience and Education:

• Bachelor’s degree or equivalent work experience

• 3+ years of testing experience required

• 3+ years of business and/or systems area specific knowledge

• Strong knowledge of claims, medical coding/billing, and NASCO, Jira, BlueSquared, MHK, and data warehouse reporting knowledge.

• Previous testing experience required including direct experience with test plan development

• Demonstrated proficiency in Microsoft software: Word, Excel, Access, and Outlook

Minimum Education Requirements:

High school degree or equivalent required unless otherwise noted above

LocationHinghamTime TypeFull time

Salary Range: $90,500.00 - $113,740.00

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that the confidence gap (https://www.theatlantic.com/magazine/archive/2014/05/the-confidence-gap/359815/) and imposter syndrome (https://www.braintreepayments.com/blog/overcoming-imposter-syndrome/) can prevent amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community (https://careers.bluecrossma.org/us/en/jointalentcommunity?applyType=JTC) to stay “in the know” on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work (https://careers.bluecrossma.org/us/en/how-we-work) " Page.

Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power , Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.

Our Commitment to You

We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance.

Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.

Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.