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H
Operations Support Specialist II
Horizon Connect @ Wall BCBSNJ. Provide guidance and support to more junior staff, including formal observations of junior coach performance and/or progress.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in health insurance operations, including claims processing and industry best practices, while providing mentorship and support to junior staff. Capable of analyzing training needs and developing effective learning solutions in collaboration with stakeholders.
Highest-signal resume keywords
Health Insurance Operations ExperienceClaims Processing ExperienceMentoring and Coaching SkillsAnalytical ThinkingOrganizational Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingData AnalysisProcess ImprovementTraining DevelopmentWorkflow Testing
Soft Skills
Interpersonal SkillsPresentation SkillsMultitaskingProblem Resolution
Tools & Technologies
PC Skills
Industry Keywords
Healthcare Industry KnowledgeBest PracticesCompetency IdentificationTalent ManagementSLA Management
About the role
Key responsibilities & impact- Provide guidance and support to more junior staff, including formal observations of junior coach performance and/or progress.
- Assist internal team members and outsourced staff with error reviews, audit inquiries, and complex work assignments.
- Participate in onboarding, competency identification, development plans, and talent management.
- Identify trends, recommend process and workflow changes, assess deficiencies, and conduct one-on-one mentoring.
- Escalate system and operations issues and assist with problem resolution.
- Produce daily educational bulletins to enhance quality.
- Collaborate with Training Quality and Operations to ensure effective learning experiences, post-training transitions, monitoring, and training alternatives.
- Conduct cross-training at Horizon sites and remote vendor locations.
- Represent Operations at cross-functional meetings and work groups.
- Assist with modifying training resources and schedules in response to staffing issues and business needs.
- Monitor provisions and recommend changes to SLAs to meet productivity and quality goals.
- Conduct gap analyses and review data/metrics to determine training needs and solutions.
- Partner with stakeholders to develop and deliver learning solutions for new products, upgraded systems, and business initiatives.
- Collaborate with Instructional Design and Knowledge Management on learning solution design and implementation.
- Test supported workflows and processes.
- Assist with inventory management and other Training & Development activities as assigned.
Requirements
What you’ll need- High School Diploma/GED required.
- 5 years experience in health insurance operations preferably in a related role.
- Requires knowledge of current industry trends and Best Practices.
- Requires healthcare industry knowledge.
- Requires claims processing experience.
- Strong PC skills.
- Organizational, Multitasking, Analytical Thinking and strong Interpersonal and Presentation Skills.
- Employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware.
Benefits
Comp & perks- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement