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This role ensures accurate and compliant adjudication of complex BlueCard claims while serving as an enterprise escalation point. The analyst leads cross-functional initiatives, monitors InterPlan performance metrics, and translates Association updates into operational actions.
Requires a high school diploma (Associate's preferred) with 5-7+ years of insurance claims experience and 3-5 years specifically in BCBS claims. Candidates must possess expert Excel skills and proven leadership experience.
HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service.
We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.
What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven.
What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/
How YOU will make a Difference:
As a BlueCard/ITS claims Specialist, this role ensures accurate, compliant adjudication across complex BlueCard claims, translates BlueWeb and Association changes into operational action, partners closely with Regence and InterPlan stakeholders, and monitors and improves IPP (InterPlan Program) performance. The Claims Specialist/BlueCard Hybrid serves as an enterprise escalation point, leads cross-functional initiatives, and drives training, quality, and process improvements that safeguard claim outcomes and member experience.
What YOU will do:
BlueWeb Review
Collaboration with Regence
Operational Change Leadership
IPP Score Monitoring
Claims Adjudication
Knowledge, Experience and Attributes:
Compensation:
The base salary range for this position in the greater Seattle area is $47.89/hr - $55.76/hr for a level IV and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level I, we may consider level II for highly qualified candidates.
Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law.
In addition, HMA provides a generous total rewards package for full-time employees that includes:
How we Support your Work, Life, and Wellness Goals
At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party.
We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.)
HMA requires a background screen prior to employment.
Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures.
HMA is an Equal Opportunity Employer.
For more information about HMA, visit: https://www.accesshma.com/
Proving What's Possible in Healthcare®
HMA is Proving What's Possible in Healthcare®. Our team of caring experts design and deliver high-quality, innovative, and affordable health plans for self-funded employers. We are the service-oriented partner brokers and employers trust to protect two of their most important assets; their people and their health plan dollars. With 40 years of industry experience and a team of proactive, highly skilled professionals, we help employers improve their bottom line. We call this “Winning Together” because we’re on the same side and share the same goals – healthier outcomes for members at the best possible value.
Offices: 10700 Northup Way, Bellevue, Washington 98004, US
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