Claims Payment Specialist — Hybrid/Remote & Process Expert

BCBS Global Solutions; King of Prussia (PA); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Hybrid work model

Paid parental leave

Telemedicine services

401(k) match

Tuition reimbursement

Employee assistance

Healthcare coverage

Job summary

BCBS Global Solutions seeks a Claims Payment Specialist to investigate and resolve payment issues across returned, rejected, and suspended reimbursements. You will coordinate with members, providers, and internal teams to ensure accurate processing and timely communications.

The role emphasizes attention to detail, data integrity, and proactive problem-solving in a hybrid work environment across US operations, with opportunities for growth and professional development.

Qualifications

• High school diploma or equivalent; further education is a plus.
• 1–2 years in customer-facing, administrative, claims, finance, or operations.
• Strong organization, problem-solving, and data entry skills.
• Ability to decide based on research and documentation.
• Clear written and verbal communication; proficient with Microsoft Office.

Responsibilities

• Analyze returned, rejected, suspended, and failed claim reimbursements.
• Review payment and claims data to identify discrepancies.
• Research and resolve payment exceptions with updated details.
• Coordinate reissuance of claim payments after corrective actions.
• Maintain professional communication with members, providers, and internal teams.
• Document findings and actions for audits and compliance.
• Support payment policy adherence and process improvements.

Skills

Attention to detail

Data entry

Problem solving

Communication

Organizational skills

Education

High School Diploma

Tools

Microsoft Office

Job description

BCBS Global Solutions seeks a Claims Payment Specialist to investigate and resolve payment issues across returned, rejected, and suspended reimbursements. You will coordinate with members, providers, and internal teams to ensure accurate processing and timely communications.

The role emphasizes attention to detail, data integrity, and proactive problem-solving in a hybrid work environment across US operations, with opportunities for growth and professional development.