Senior Associate Member Claims Processing

Job Summary

Leading the operational execution of member claim processing for the Medicare Advantage business, the full-time Senior Associate Member Claims Processing will manage complex claims, ensure timely processing, and collaborate with various teams to enhance accuracy and compliance in a remote work environment.

Key responsibilities

• Own day-to-day operational execution of member claim processing, including complex and escalated claims
• Monitor claim timeliness, inventory, and turnaround time, addressing bottlenecks to mitigate compliance risks
• Partner with cross-functional teams to provide feedback on processing errors and support member claim appeals

Required qualifications

• Bachelor's degree or equivalent work experience
• Strong writing ability to craft clear and persuasive communications to members
• Experience in healthcare, healthcare technology, or tech operations preferred
• Proven ability to thrive in a fast-paced environment
• Track record of maintaining process documentation that is clear and actionable