Payment Policy Sr. Specialist

The Payment Integrity Consultant at Blue Cross Blue Shield of MA serves as a subject matter expert on facility payments, using payment policy and business operations knowledge to inform reimbursement strategy. The role supports implementation and execution of facility reimbursement and payment integrity initiatives, including analyzing claims data and assessing financial impacts. The position collaborates across teams to develop and maintain payment policies, claim editing logic, fee schedules, and vendor relationships to improve affordability and payment accuracy.