BPO Oversight Specialist III Job at Blue Cross Blue Shield of Arizona (Phoenix)

BPO Oversight Specialist III

Blue Cross Blue Shield of Arizona

Location:
United States , Phoenix

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Not provided

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Job Description:

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

Job Responsibility:

On behalf of internal and external customers, gather and document business requirements, provide research and analysis related to project deliverables or production (break/fix) issues, conduct user acceptance testing (UAT), and act as a liaison between business customers, external customers, project teams and IT
Write and review business requirements, flow specifications or change requests
Write test scripts, perform testing and post-production validation
Conduct research and analysis for issue resolution relating to electronic transactions, customer service applications, claim adjudication systems including reporting, process efficiencies. Track all items through to resolution
Provide first or second level support for internal/external customers
Utilize problem-solving skills to improve procedures and processes, resolve system deficiencies and implement enhancements
Act as a liaison between external/internal customers and IT
communicate system and process changes to business areas
Develop moderate complex (e.g. multiple departments/systems) business requirements on large projects and flow specifications with limited management direction
Provide support to external customers to onboard Healthcare EDI processing and achieve HIPAA Transaction and Code Set compliance
Provide subject matter expert (SME) advice related to electronic transactions and other corporate systems in the prioritization of workload or issue research
Facilitate and/or create new operational procedures and processes resulting from advancing technologies or capabilities
Lead small to medium size projects
act as UAT Coordinator including test strategy and plan development
Interpret design specifications for comparison against defined business needs to ensure compatibility, consistency and completeness
Resolve differences between customers and other team members in order to achieve organizational and project goals
Utilize existing reporting tools to develop and execute data queries for ad hoc requests
understand data source structures
Understand EDI formats/syntax and file transfer protocols
Support multiple segments of business
Mentors Level 1 Analysts
Develop complex (e.g. multiple departments/systems) business requirements on large projects and flow specifications with little to no management direction
Decompose high-level project information and evaluates project components to forecast work effort required
Act as lead business analyst for large or complex projects
Interpret business and technical design specifications and resolve conflicts that arise when compared against the defined needs of the business
Fully support all business segments
Mentors Level 1 and 2 Analysts
Ensures Service Level Agreements between department and operational or technical areas are met
Act as lead business analyst for large or complex projects with minimal guidance from lead or manager
Mentors all level of analysts
Proactively seeks opportunities to improve processes and procedures in support of customer satisfaction and corporate goals
Participate in on-call rotation

Requirements:

2 years of experience in a role with demonstrated ability to communicate with diverse groups of people inside and outside of the business
2 years of experience triaging issues from start to finish for members and/or providers
3 years of experience in healthcare or operations
3 years of experience in healthcare production field or quality auditing field
3 years of experience in developing and implementing process improvement initiatives
High-School Diploma or GED in general field of study
Strong analytical skills to support independent and effective decisions based on customer input and research
Strong problem-solving skills
Strong time management skills
Basic skills with core MS products: Word, Excel, IE, Outlook, Visio, PowerPoint
Basic skills with query tools
Strong understanding of file handling and data translation
Excellent verbal and written communication skills and the ability to interact professionally and maintain positive working relationships with a diverse group
Prioritize tasks and work multiple priorities, sometimes under strict time constraints
Ability to build synergy with a diverse team in an ever-changing environment
Ability to exercise independent judgment and demonstrate creative problem solving techniques
Anticipates downstream impacts and factors in those considerations appropriately
Perseverance in the face of resistance or setbacks
Support priorities and direction of corporate leadership
Ability to apply sound management decision making skills to perform effectively in the absence of management
Effectively deal with conflict

Nice to have:

1 year of experience in project management
1 year of management experience
3 years of experience triaging issues from start to finish for members and/or providers
5 years of experience in a role with demonstrated ability to communicate with diverse groups of people inside and outside of the business
5 years of experience in healthcare or operations
5 years of experience in healthcare production field or quality auditing field
5 years of experience in healthcare or insurance field with an emphasis on Business Analysis
Bachelor’s Degree in Computer Science, Information Systems, Business, or related field
Demonstrates an advanced knowledge of and experience with the development of business requirements, user acceptance testing and their supporting toolsets
Familiar with HIPAA compliance validation tools such as EDISM, Specbuilder or ClarEDI
Familiar with claims and customer service processes
Experience with web portal business user support and change management activities
Formal business analyst training
Driven to identify solutions to meet customer needs
Ability to work with ambiguous and conflicting information while keeping focused on the end goal
Performs public speaking presentations within the industry

Additional Information:

Job Posted:
April 16, 2026

Employment Type:

Fulltime

Work Type:

Hybrid work

Blue Cross Blue Shield of Arizona - All Job Offers

Job Link Share:

BPO Oversight Specialist III

Blue Cross Blue Shield of Arizona

Location:
United States , Phoenix

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
April 16, 2026

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Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:April 16, 2026

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