Blue Claim Routing Analyst, Delivery

Are you seeking an exciting opportunity to join a passionate, growing, and dynamic team of professionals who support patients?

The Blue Claim Routing (BCR) Analyst supports the Delivery team by identifying, validating, and managing Blue Cross Blue Shield routing opportunities for hospital and health system clients. This role combines healthcare reimbursement analysis, claims review, and workflow management to ensure accurate identification, execution, and tracking of routing opportunities. The analyst also evaluates claims data, monitors outcomes, and communicates with internal teams and clients to maximize reimbursement while maintaining accurate documentation and reporting.

What’s Attractive to the Right Candidate?

• Knowtion Health is a growing firm in a growing industry. Our status as a leader in this industry means that we have the resources to invest in the business and to innovate.
• Our business is intensely competitive and is constantly evolving. We quickly identify new challenges and develop solutions, so you won’t simply be doing what was done last year. Our new employees are frequently pleased and surprised by how quickly we make decisions and adapt to market conditions.
• Knowtion Health culture is inviting and competitive, embracing challenge and celebrating accomplishment; dedicated colleagues striving to provide quality results that have lasting impact.

The Opportunity:

• Review hospital claims data to identify potential Blue Cross Blue Shield routing opportunities.
• Validate eligibility of claims for routing based on payer rules, plan prefixes, member plan location, and service location.
• Assess claim attributes including payer identification, member coverage information, place of service, and billing details to determine routing viability.
• Evaluate potential financial impact and prioritize opportunities based on likelihood of success and reimbursement value.
• Ensure routing activities comply with internal processes and client engagement requirements.

What you bring:

• Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field preferred.
• 1+ years of experience in healthcare revenue cycle operations, claims analysis, or payer reimbursement preferred.
• Familiarity with Blue Cross Blue Shield plans, BlueCard programs, or multi-payer claim environments is highly desirable.
• Strong analytical skills with the ability to review large claim datasets and identify reimbursement opportunities.

The above statements are intended to provide the general nature and level of work being performed by most people assigned to the position. They are not intended to be an exhaustive list of all responsibilities, duties and requirements.

This position is remote and requires a dedicated, distraction-free work space at home. We offer a competitive benefits package including medical, dental, vision, life insurance, short term disability, long term disability, paid holidays, 401k, and a generous PTO policy.

Knowtion Health gives priority to applicants located in the following states: AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, WV

Photo Identification and Image Capture Notice

As part of our hiring process, candidates are required to present a valid government-issued photo ID during screening and/or interviews.

We may also capture a photograph during the screening or interview process for identity verification, security, and record-keeping purposes. All identification documents and images will be handled in accordance with applicable privacy laws and accessed only by authorized personnel.

By proceeding with your application, you acknowledge and consent to this process.