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Enrollment Processor, Intermediate
Career Insights for Claims Processor
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Scorecard
Based on California data
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What they do
A Claims Processor reviews and processes insurance claims and determines whether an insurance policy will cover a claim. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a claim is approved.
$48,411 / year median in California
-8% projected decline
Job Description
Enrollment Processor, Intermediate Blue Shield of CA United States, California, El Dorado Hills 4205 Town Center Boulevard (Show on map) Sep 01, 2026 Your Role The IFP Install and CEC team support our consumer line of business by managing the eligibility and reconciliation of our IFP membership for both on and off-exchange membership. The Enrollment Processor, Intermediate will report to the Operations Supervisor, IFP Install. In this role you will review and reconcile eligibility data, support our vendor team with clarifications and work with internal and external stakeholders to ensure our IFP membership has accurate eligibility and rates. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Requires High School Diploma or GED
Requires at least 3 years of prior relevant experience in Health Insurance (e.g., claims, customer service, processing)
Knowledge of Covered California Eligibility guidelines and enrollment processing preferred
Knowledge of Facets, SAS, Edifecs, PEGA, & CalHeers preferred
Intermediate-Advanced skills creating documents/files using Excel, Outlook, Power Point, and Word Hybrid Virtual Work This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.