About this 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's simple, efficient, and human.
Whether our customers live, work, travel or study abroad, we give them the confidence and peace of mind to embrace every journey and say "yes" to new possibilities.
The Supervisor, Claims Systems is a hybrid leadership and hands-on role responsible for the day-to-day operation, support, and continuous improvement of claims administration systems. This position combines direct oversight of a team with active involvement in system configuration, issue resolution, and implementation activities. The role ensures claims systems operate accurately, efficiently, and in compliance with business and regulatory requirements, while also contributing directly to key system initiatives and operational deliverables.
Responsibilities:
Claims Systems Oversight & Hands-On Support
Oversee daily operation and performance of claims administration systems, including Actisure and related platformsPerform hands-on system configuration and maintenance, including benefit plans, provider setup, code sets, user roles, permissions, and claims correspondenceMonitor system functionality and directly address issues impacting claims processing accuracy, timeliness, and complianceMaintain system controls and ensure adherence to operational standards Operational Change & Product Enablement
Translate business and operational changes (e.g., new products, benefit updates, enrollment changes, regulatory requirements) into system requirementsConfigure, review, and validate system updates to ensure accuracy prior to releaseParticipate directly in system build, testing, and validation activitiesEnsure alignment between Enrollment and Claims for eligibility, benefits, and adjudication logicCollaborate with IT, Product, Enrollment, Finance, Compliance, and vendors on system enhancements, upgrades, integrations, and defect resolutionLead and execute user acceptance testing (UAT), including test planning, scripting, execution, and defect resolution and support implementation readiness and perform post-release validation activitiesServe as a primary point of contact for Claims Systems-related questions, issues, and initiatives. Risk Management, Compliance & Controls
Ensure claims systems and configurations comply with regulatory requirements, contractual obligations, and internal policiesParticipate in and support audits (e.g., SOC and other internal/external audits), including documentation, testing, and remediationMonitor system performance and operational trends; take direct action to resolve risks and control gaps. People Leadership & Work Execution
Supervise and support a team of claims system analysts while also carrying an individual workloadAssign and prioritize teamwork alongside personal responsibilities to ensure timely delivery of system updates and issue resolutionProvide coaching, guidance, and feedback while reinforcing accountability and quality of workStep in to perform analyst-level work as needed to support team capacity and critical initiatives Requirements:
1+ years of leadership experience2+ years of experience in claims operations, claims systems, or business systems analysis within healthcare or insuranceExperience working with claims administration platforms (e.g., Actisure, Guidewire, or similar systems)Experience supporting system implementations, enhancements, and testing activities Strong understanding of claims processing workflows and system configurationsExperience translating business requirements into system specificationsProficiency in data analysis and reporting (e.g., Excel, SQL, or similar tools preferred)Familiarity with system testing methodologies (UAT, regression testing)Ability to translate business and product requirements into operational system solutions.Knowledge of claims lifecycle, benefit structures, and eligibility processesUnderstanding of regulatory and compliance requirements impacting claims processingExposure to payment integrity and reconciliation processes preferred What you'll get in return:
Competitive base pay + annual bonus Competitive medical plansTelemedicine availablePaid parental leaveEmployee assistance and wellness support 24/7Free international healthcare coverage Other Great Perks:
Work abroad arrangements available Generous PTO accrual program with carry-over option9 paid holidays in addition to one floating holiday and one volunteer dayTuition reimbursementCareer/Learning and development opportunities401(k) with generous company matchPet insurance offeringsIdentity theft and legal coverages available Emphasis on well-being (Virtual well-being platform, monthly mindfulness events, and giveaways)