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Bcbs Claims Jobs (NOW HIRING)

Urology Associates, P.C. - Nashville, TN

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Medical Office Manager

Nashville, TN · On-site

$62K - $75K/yr

Gym Membership Discount through BCBS of TN * Discount on Verizon phone coverage, simply for working ... Works the Hold Report to ensure insurance claims are submitted in a timely fashion. * Schedules ...

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Bcbs Claims information

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$11

$24

$42

How much do bcbs claims jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for bcbs claims in the United States is $24.12, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $27.40 per hour, depending on experience, location, and employer.

What are BCBS claims?

BCBS claims refer to the requests for payment that healthcare providers submit to Blue Cross Blue Shield (BCBS) insurance on behalf of patients who have received medical services. These claims include details about the patient's treatment, diagnosis, and the costs incurred. Once submitted, BCBS reviews the claim to determine which services are covered under the patient’s insurance plan and how much will be paid to the provider. The process also helps ensure that policyholders receive their benefits according to their health plan. Proper claims handling is essential for timely reimbursements and efficient healthcare administration.

What are the key skills and qualifications needed to thrive as a BCBS Claims Specialist, and why are they important?

To thrive as a BCBS Claims Specialist, you need a solid understanding of health insurance policies, medical billing, and claims processing, typically supported by experience in healthcare administration or a related field. Familiarity with claims management software, ICD-10/CPT coding systems, and electronic data interchange (EDI) platforms is essential. Strong attention to detail, analytical thinking, and effective communication are crucial soft skills for resolving discrepancies and assisting clients or providers. These skills ensure accurate claims adjudication, regulatory compliance, and efficient resolution of issues within the health insurance process.

What are some common challenges faced by professionals handling BCBS claims, and how can they be managed effectively?

Professionals working with BCBS (Blue Cross Blue Shield) claims often encounter challenges such as navigating complex insurance policies, ensuring accurate coding, and managing claim denials or rejections. Staying up to date with changing regulations and payer requirements is crucial to avoid processing errors. Effective communication with healthcare providers and insurance representatives, along with strong attention to detail, can help resolve discrepancies quickly and ensure timely claim resolution. Utilizing claim management software and participating in ongoing training are also beneficial for staying efficient and compliant.

What is the difference between Bcbs Claims vs Bcbs Customer Service Representative?

AspectBcbs ClaimsBcbs Customer Service Representative
Required CredentialsInsurance claims processing certification, knowledge of healthcare policiesCustomer service training, communication skills, insurance knowledge
Work EnvironmentOffice setting, claims processing departmentsCall centers, customer support centers
Employer & Industry UsageHealth insurance companies, healthcare industryHealth insurance companies, customer support roles
Common Search & ComparisonClaims processing, insurance claimsCustomer support, member inquiries

While Bcbs Claims specialists focus on processing and managing insurance claims, Bcbs Customer Service Representatives handle member inquiries and support. Both roles are essential in the healthcare insurance industry but differ in responsibilities and daily tasks.

More about Bcbs Claims jobs
What cities are hiring for Bcbs Claims jobs? Cities with the most Bcbs Claims job openings:
What states have the most Bcbs Claims jobs? States with the most job openings for Bcbs Claims jobs include:
What job categories do people searching Bcbs Claims jobs look for? The top searched job categories for Bcbs Claims jobs are:
Bcbs Claims jobs near you
Infographic showing various Bcbs Claims job openings in the United States as of June 2026, with employment types broken down into 98% Full Time, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $50,180 per year, or $24.1 per hour.
Billing Specialist

Billing Specialist

Arthritis & Rheumatology Center PC

Roswell, GA • On-site

$22 - $23/hr

Full-time

Medical, Dental, Vision, Life, Retirement

This job post has expired today. Applications are no longer accepted.

Job description

Job Summary:

We are a growing Arthritis and Rheumatology Center located in Roswell, Ga, seeking a detail-oriented and experienced Accounts Receivable (A/R) Specialist to join our team. The ideal candidate will have a strong understanding of medical insurance processes, payer policies, and reimbursement procedures. This position is responsible for reviewing and resolving outstanding insurance balances, interpreting Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs), and working closely with insurance payers to ensure timely and accurate payments.

Key Responsibilities:

  • Maintain full ownership of assigned A/R aging report, prioritizing accounts based on payer deadlines and dollar value

  • Aggressively follow up on unpaid, underpaid, and denied claims to ensure timely reimbursement

  • Analyze aging balances and take immediate corrective action to prevent accounts from exceeding payer timely filing limits

  • Research claim issues and resolve them in accordance with individual payer regulations, contracts, and billing guidelines

  • Identify root causes of denials and payment delays and implement corrective actions

  • Submit corrected claims, appeals, and reconsiderations within payer-specific timeframes

  • Review EOBs and remittance advice to ensure payments align with contracted rates

  • Escalate unresolved or systemic payer issues with clear documentation and recommendations

  • Communicate professionally and effectively with insurance carriers to resolve discrepancies

  • Collaborate with billing, coding, and front-office staff to reduce recurring claim errors

  • Maintain strict compliance with HIPAA, payer rules, and practice policies

  • Prepare and review A/R and aging reports and provide regular status updates to management

Requirements:

  • 2+ years of experience in medical billing, A/R follow-up, or insurance claims resolution.

  • Strong understanding of insurance processes (commercial plans, Medicare, BCBS, United Healthcare, etc).

  • Proficient in reading EOBs, ERAs, and payer remittance summaries.

  • Experience working payer A/R and resolving outstanding claims.

  • Excellent verbal and written communication skills for interacting with payers and internal teams.

  • Ability to work independently, manage time effectively, and prioritize tasks.

  • Familiarity with billing software and eClinicalworks is a must!

Preferred Skills:

  • Experience with high-volume A/R follow-up.

  • Knowledge of CPT, ICD-10, and HCPCS coding.

  • Previous experience working with specific payers (e.g., Aetna, UnitedHealthcare, Blue Cross Blue Shield, Medicare).

  • Demonstrate consistent compliance with payer regulations and deadlines

  • Identify trends and recommend process improvements to prevent revenue loss


BENEFITS:

  • 401(k) matching
  • Dental Insurance
  • Health Insurance
  • Life Insurance
  • Vision Insurance


SCHEDULE:

  • 8-hour shift
  • Monday-Friday
  • In person-Roswell, Ga Location


WORK SETTING:

  • Clinic
  • Office