About the role
Who we are.
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.
What we're looking for in our Claims Payment Specialist
You're someone who enjoys solving problems, investigating details, and ensuring payments are handled accurately from start to finish. You thrive in a process-driven environment and take pride in delivering a positive experience for members, providers, and internal partners. You're naturally curious, organized, and committed to finding solutions when payment issues arise.
You're someone who
Has a strong attention to detail and enjoys researching discrepancies
Takes ownership of issues and follows through to resolution
Communicates effectively with customers, providers, and cross-functional teams
Balances quality, accuracy, and productivity in a fast-paced environment
Enjoys uncovering root causes and improving outcomes through problem-solving
Can navigate multiple systems and processes while maintaining organization and accuracy
Here's the work you'll be doing to support claims payment operations
Payment Investigation & Resolution
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
Member, Provider & Internal Partner Support
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
Refund Processing & Financial Accuracy
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
Quality, Compliance & Continuous Improvement
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
This might be the right fit for you if...
You have a high school diploma or equivalent; additional education or coursework is a plus
You have 1-2 years of experience in a customer-facing, administrative, claims, finance, accounting, or operations-related role
You have strong organizational, problem-solving, and data entry skills
You're comfortable making decisions based on research and supporting documentation
You communicate clearly and professionally, both verbally and in writing
You are proficient with Microsoft Office and comfortable learning new systems and technologies
You can effectively manage multiple priorities while maintaining accuracy and attention to detail
Bonus points if you have
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
What you'll get in return
Competitive base pay + annual bonus
Competitive medical plans
Telemedicine services
Paid parental leave
24/7 employee assistance and wellness support
Free international healthcare coverage
Other great perks
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
Please visit the employee benefits page on our website for more information on our benefits and perks that support your overall well-being.
EOE