About the role
Who we are.
At Blue Cross Blue Shield Global SolutionsSM (BCBS Global SolutionsSM), 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 is 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 Analyst
You're a detail-oriented problem solver who enjoys analyzing information and ensuring healthcare claims are processed accurately and efficiently. You understand that behind every claim is a member seeking support, and you're committed to delivering quality outcomes that help members access the benefits they deserve.
You're someone who
Has a passion for accuracy and consistently delivers high-quality work
Enjoys research and investigation to understand complex claim scenarios
Can confidently interpret healthcare and insurance information
Balances productivity with attention to detail
Thrives in a fast-paced environment where priorities and workloads may shift
Communicates effectively and collaborates well with teammates and business partners
Takes ownership of their work and is committed to continuous learning and improvement
Here's the work you'll be doing to support our members around the world
Claims Analysis & Processing
Review and analyze international healthcare claims to determine services rendered, charges, and eligibility for payment
Investigate claim details and gather necessary information to ensure accurate adjudication and processing
Maintain complete and accurate claim documentation and records
Translate international medical invoices and supporting documentation when appropriate
Claims Adjudication & Coding
Process claims according to benefit plans, policy provisions, and established claim handling procedures
Apply appropriate medical coding standards, including ICD-10, CPT, and Place of Service coding when required
Ensure accurate data entry and claim setup to facilitate proper claim adjudication and settlement
Process claims in accordance with specific program requirements
Quality & Performance Excellence
Meet departmental productivity, accuracy, and quality standards
Adhere to service level agreements and claim processing requirements
Identify trends, discrepancies, or issues that may impact claim outcomes
Escalate concerns and collaborate with leadership to resolve claim-related challenges
Collaboration & Continuous Improvement
Partner with peers and cross-functional teams to support operational excellence
Stay current on policy updates, claim procedures, and industry regulations
Contribute ideas that improve efficiency, accuracy, and the overall member experience
Support special projects and additional responsibilities as assigned
What success looks like
The Claims Analyst will be expected to drive positive outcomes through:
Accurate and timely claim processing
Strong productivity and quality performance
Consistent adherence to service level commitments
Effective use of coding and claim adjudication knowledge
Positive collaboration with internal partners and team members
Delivery of an exceptional member experience through accurate claim resolution
This might be the right fit for you if...
You have a high school diploma or equivalent; additional education is a plus
Your resume includes 3+ years of health insurance claims processing, adjudication, or related experience
You have experience reviewing medical claims and interpreting benefit plans
You possess strong analytical, organizational, and problem-solving skills
You are comfortable making informed decisions and documenting claim determinations
You have strong written and verbal communication skills
You can effectively manage multiple priorities while maintaining attention to detail
You are proficient with Microsoft Office and comfortable learning new systems and technologies
Bonus points if you have
Experience processing international medical claims
Knowledge of BCBS Global Core or Federal Employee Program (FEP) claims
Familiarity with CPT, ICD-10, and medical coding practices
CPC, CCS, or other coding certifications
Experience with automated claims adjudication platforms
Health insurance industry expertise, particularly in international healthcare
Blue Cross Blue Shield experience
What you'll get in return
Competitive base pay
Competitive medical plans
Telemedicine services
Paid parental leave
Employee assistance and wellness support
Free international healthcare coverage
Other great perks
Hybrid and remote work opportunities where applicable
Generous PTO
Paid holidays, floating holiday, and volunteer day
Tuition reimbursement
Career development opportunities
401(k) with company match
Pet insurance, identity theft, and legal coverage
Please visit the employee benefits page on our website for more information on our benefits and perks that support your overall well-being.
EOE