Claims Systems Leader — Hybrid & Hands-On

BCBS Global Solutions; King of Prussia (PA); Hybrid; USD 110,000 - 140,000; Full time

Benefits offered by this job

Annual bonus

Medical plans

Telemedicine

Parental leave

Well-being program

Global coverage

Work abroad

PTO carryover

Job summary

Blue Cross Blue Shield Global Solutions seeks a Supervisor, Claims Systems to lead daily operations, configure systems, and ensure compliant, efficient claims processing. This hybrid role requires coordinating with IT, Product, Enrollment, and Finance while guiding a team of analysts.

You will drive system builds, testing, and UAT, translating business needs into technical specs and ensuring alignment across enrollment and adjudication logic.

Qualifications

• 1+ years of leadership experience.
• 2+ years in claims operations or related healthcare/insurance domain.
• Experience with claims platforms (Actisure, Guidewire) and system configurations.
• Experience translating business requirements into system specifications.
• Proficiency in data analysis tools (Excel, SQL).

Responsibilities

• Oversee daily operation and performance of claims administration systems.
• Configure and maintain system settings including benefit plans, provider setup, code sets, and user roles.
• Monitor system functionality and address issues impacting accuracy and compliance.
• Lead and execute user acceptance testing (UAT) and defect resolution.
• Collaborate with IT, Product, Enrollment, Finance, Compliance, and vendors on enhancements and upgrades.
• Supervise a team of claims system analysts and manage workload.

Skills

Leadership

Claims operations

Claims systems

Systems analysis

Data analysis

Tools

Actisure

Guidewire

SQL

Job description

Blue Cross Blue Shield Global Solutions seeks a Supervisor, Claims Systems to lead daily operations, configure systems, and ensure compliant, efficient claims processing. This hybrid role requires coordinating with IT, Product, Enrollment, and Finance while guiding a team of analysts.

You will drive system builds, testing, and UAT, translating business needs into technical specs and ensuring alignment across enrollment and adjudication logic.