Claims Payment Specialist
About The Position
At Blue Cross Blue Shield Global Solutions℠ (BCBS Global Solutions℠), we make it easy for people and organizations to access and pay for healthcare abroad. By combining digital innovation with human-centered care, we go above and beyond for our customers and deliver an international healthcare experience that's simple, efficient, and human. Whether our customers live, work, travel, or study abroad, we give them the confidence and peace of mind to say "yes" to new possibilities. We are looking for a Claims Payment Specialist who enjoys solving problems, investigating details, and ensuring payments are handled accurately from start to finish. This role thrives in a process-driven environment and takes pride in delivering a positive experience for members, providers, and internal partners. The ideal candidate is naturally curious, organized, and committed to finding solutions when payment issues arise.
Requirements
- High school diploma or equivalent
- 1-2 years of experience in a customer-facing, administrative, claims, finance, accounting, or operations-related role
- Strong organizational, problem-solving, and data entry skills
- Comfortable making decisions based on research and supporting documentation
- Communicate clearly and professionally, both verbally and in writing
- Proficient with Microsoft Office and comfortable learning new systems and technologies
- Effectively manage multiple priorities while maintaining accuracy and attention to detail
Nice To Haves
- Additional education or coursework
- Experience with health insurance claims or payment processing
- Exposure to accounting, finance, or reimbursement functions
- Experience working with CRM, claims administration, or payment systems
- Knowledge of healthcare reimbursement processes
- Experience working in a regulated or compliance-focused environment
- Experience supporting remote or cross-functional teams
Responsibilities
- Analyze returned, rejected, suspended, and failed claim reimbursements to determine the cause of payment issues
- Review payment and claims information to identify discrepancies and ensure accurate reimbursement processing
- Research and resolve payment exceptions by updating electronic payment details and mailing information
- Coordinate the reissuance of claim payments after validating corrective actions
- Contact members and healthcare providers to obtain accurate payment information and address updates
- Serve as a liaison between Claims, Finance, Customer Service, and other internal teams to facilitate payment resolutions
- Request and monitor wire tracers and other payment investigations to support inquiries and issue resolution
- Maintain professional, timely communication with internal and external stakeholders throughout the resolution process
- Review and analyze refund payments received from members and providers related to overpayments or incorrect reimbursements
- Partner with appropriate teams to ensure proper claim credits and payment adjustments are processed
- Document findings, actions taken, and outcomes to support audit and compliance requirements
- Help ensure payment activity aligns with company policies, procedures, and service standards
- Maintain departmental productivity and quality standards
- Accurately document payment research, decisions, and supporting information
- Identify trends, recurring issues, and opportunities for process improvements
- Support departmental initiatives and other responsibilities as assigned
- Follow all company policies, procedures, and regulatory requirements
Benefits
- Competitive base pay + annual bonus
- Competitive medical plans
- Telemedicine services
- Paid parental leave
- 24/7 employee assistance and wellness support
- Free international healthcare coverage
- Hybrid work model (office and/or remote)
- Work-abroad arrangements available
- Generous PTO accrual with carry-over options
- 9 paid holidays, plus one floating holiday and one volunteer day
- Tuition reimbursement
- Career development and learning opportunities
- 401(k) with generous company match
- Pet insurance options
- Identity theft and legal coverage
- Ongoing focus on well-being, including virtual wellness resources and mindfulness events
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
