Claims Payment Specialist

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 discrepanciesTakes ownership of issues and follows through to resolutionCommunicates effectively with customers, providers, and cross-functional teamsBalances quality, accuracy, and productivity in a fast-paced environmentEnjoys uncovering root causes and improving outcomes through problem-solvingCan 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 issuesReview payment and claims information to identify discrepancies and ensure accurate reimbursement processingResearch and resolve payment exceptions by updating electronic payment details and mailing informationCoordinate 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 updatesServe as a liaison between Claims, Finance, Customer Service, and other internal teams to facilitate payment resolutionsRequest and monitor wire tracers and other payment investigations to support inquiries and issue resolutionMaintain 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 reimbursementsPartner with appropriate teams to ensure proper claim credits and payment adjustments are processedDocument findings, actions taken, and outcomes to support audit and compliance requirementsHelp ensure payment activity aligns with company policies, procedures, and service standards Quality, Compliance & Continuous Improvement Maintain departmental productivity and quality standardsAccurately document payment research, decisions, and supporting informationIdentify trends, recurring issues, and opportunities for process improvementsSupport departmental initiatives and other responsibilities as assignedFollow 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 plusYou have 1-2 years of experience in a customer-facing, administrative, claims, finance, accounting, or operations-related roleYou have strong organizational, problem-solving, and data entry skillsYou're comfortable making decisions based on research and supporting documentationYou communicate clearly and professionally, both verbally and in writingYou are proficient with Microsoft Office and comfortable learning new systems and technologiesYou can effectively manage multiple priorities while maintaining accuracy and attention to detail Bonus points if you have: Experience with health insurance claims or payment processingExposure to accounting, finance, or reimbursement functionsExperience working with CRM, claims administration, or payment systemsKnowledge of healthcare reimbursement processesExperience working in a regulated or compliance-focused environmentExperience supporting remote or cross-functional teams What you'll get in return: Competitive base pay + annual bonusCompetitive medical plansTelemedicine servicesPaid parental leave24/7 employee assistance and wellness supportFree international healthcare coverage Other great perks: Hybrid work model (office and/or remote)Work-abroad arrangements availableGenerous PTO accrual with carry-over options9 paid holidays, plus one floating holiday and one volunteer dayTuition reimbursementCareer development and learning opportunities401(k) with generous company matchPet insurance optionsIdentity theft and legal coverageOngoing 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