Blue Cross and Blue Shield of Nebraska · 20 hours ago
Plan Performance Auditor
Work at Home - Nebraska
Full-time
Hybrid
Entry Level
2+ years expBlue Cross and Blue Shield of Nebraska is a mission-driven organization dedicated to championing the health and well-being of its members and communities. The Plan Performance Auditor will be responsible for reviewing and analyzing claim, enrollment, and inquiry transactions to ensure compliance with regulatory requirements and maintain the integrity of transaction processing.
Insurance
Responsibilities
Perform quality reviews/audits of claim, enrollment and inquiry transactions
Research issues identified in reviews by performing additional investigation into applicable documentation, as well as collaborating with operations personnel
Communicate/report errors and findings to the appropriate stakeholders
Assist with other Plan Performance audit/work as needed
Collaborate and serve as a corporate resource to other departments or operational areas
Coordinate and organize daily workflow, maintain documentation, attend meetings and other administrative activities
Qualification
Required
Associate's degree in business or related field and 2 years' experience in the health care industry with claims auditing or claims processing experience
Knowledge of medical terminology and ICD10/ CPT coding
The ability to meet or exceed the attendance and timeliness requirements of their departments
The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily
Preferred
Knowledge of BCBSNE, BlueCard & FEP Operational departments and processing systems
High attention to detail
Ability to meet deadlines and time constraints
Ability to work well with others
Strong analytical and problem solving skills
Strong verbal and written communication skills
Knowledge of auditing procedures and methodologies
Knowledge of various software applications including, but not limited to Microsoft Word, Excel and Outlook
Strong research and quality/auditing skills
Knowledge of CXOne and the CSC process
Knowledge of PowerBI & SRS reporting
Knowledge of Office products: specifically Excel and Word
Company
Blue Cross and Blue Shield of Nebraska
Blue Cross and Blue Shield of Nebraska is the state’s oldest and largest health insurance company, based in Omaha.
1001-5000 employees
H1B Sponsorship
Blue Cross and Blue Shield of Nebraska has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (10)
2024 (9)
2023 (16)
2022 (15)
2021 (12)
2020 (27)
Funding
Current Stage
Late StageLeadership Team
Chad Werner
EVP and Chief Financial Officer
Steve Konnath
SVP, Chief Actuary and Analytics Officer, Senior Market Segment Leader
Recent News
Fierce Healthcare
2025-07-04
Company data provided by crunchbase