Hybrid Enrollment Processor, Specialist presso Blue Shield of California

Your Work

In this role, you will:

• Regularly contact internal and external customers and business partners to verify or obtain additional information to complete processing work
• Refer discrepancies in source documents to appropriate person and assist in correcting the document
• Monitor schedules, workflow, and priorities, communicating with supervisors/team members as needed to ensure effective teamwork
• Assist in process-related issues and acts as a resource for process related issues/problems and their resolution
• Make recommendations to management for improvements in business processes and desk-level procedures
• Manage inventory across multiple lines of business, ensuring cycle times, service level agreements and performance guarantees are met
• Direct and coach team members to ensure production and quality measures are met on a monthly basis, in partnership with the supervisor
• Act as a back-up for supervisor, leading calls, team huddles and representing the department with internal and external stakeholders
• Partner with internal and external stakeholders to ensure customers receive high-quality, consistent experience 
• Manage department specific desktop level procedures, training content, and projects as warranted by business needs 

Your Knowledge and Experience

• Requires a minimum of 7 years of relevant experience
• Requires Advanced-Expert skills creating documents/files using Excel, Outlook, Power Point, and Word
• Requires Health Plan Operations Group level experience (i.e. claims, billing, processing, etc.)
• Requires experience working cross-functionally and explaining complex concepts at all levels 
• Experience with Facets and Salesforce, a plus 
• Experience leading a team, providing coaching and feedback, reporting out on inventory, prioritizing tasks, leading meetings
• Self-driven and able to operate in the best interests of our clients, our company, and team with limited supervision or oversight

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies. 

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. 

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!  

Our Values: 

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short. 
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals. 

Our Workplace Model:

At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose – whether working in the office or through a hybrid approach – by providing clear expectations while respecting the diverse needs of our workforce.

Two Ways of Working:

• Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions:

o   Member-facing and approved out-of-state roles remain remote.

o   Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.

o   For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

• On-Site: Work from a business unit-approved office an average of four (4) or more days a week.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail. 

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.