Care Navigator

Job Summary

To support members on a US health insurance plan, the full-time Care Navigator will manage member inquiries, assist with navigating benefits and appeals processes, and coordinate between members and providers while working remotely.

Key responsibilities

• Serve as the primary contact for members facing billing, denial, or complex questions regarding their insurance
• Assist members in navigating the appeals process and review complex cases as they arise
• Translate plan design and benefits into clear language to ensure members understand their coverage

Required qualifications

• Several years of experience in a medical-administrative or patient-facing coordination role
• Hands-on experience with claims, medical billing, and pre-authorizations
• Familiarity with CPT and ICD coding
• Ability to coordinate effectively across members, providers, and payers
• Prior experience on the payer or claims-administration side of health insurance is a plus