What's your preference?
Job Description
- Req#: 7f8025f4-3b6f-466e-bae9-9b3fa8a54686
Employer Industry: Health Benefits Solutions
Why consider this job opportunity:
- Salary up to $98,750 annually
- Unique benefits package including alternative medicine coverage, generous PTO, and up to 16 weeks paid parental leave
- Opportunity for career advancement and meaningful mission-driven work
- Supportive and collaborative work environment with a focus on employee well-being
- Flexibility to adapt work schedules based on business needs
What to Expect (Job Responsibilities):
- Oversee, mentor, and evaluate claims examiners, ensuring performance management and KPI monitoring
- Lead claims processing and inventory management for timely and compliant claims adjudication
- Analyze quality review findings to identify and address root causes of errors in claims processing
- Act as the escalation point for complex claims, leading investigations and implementing corrective solutions
- Collaborate cross-functionally with internal departments to improve policies and procedures
What is Required (Qualifications):
- Strong understanding of medical terminology, CPT/ICD codes, and claims adjudication systems
- Demonstrated ability to motivate, train, and evaluate staff while achieving departmental goals
- Previous experience leading and managing claims examiners with a focus on process development
- Excellent written and verbal communication skills for team and external interactions
- Ability to manage multiple priorities and navigate ambiguity effectively
How to Stand Out (Preferred Qualifications):
- Previous experience at a high-growth company
- Familiarity with state/federal healthcare laws and regulations
- Previous experience using Javelina
- Experience managing dynamic inventory
- Demonstrated success in leading special projects with impactful results
#HealthBenefits #HealthcareManagement #ClaimsProcessing #CareerGrowth #EmployeeBenefitsAbout the company
Hi, we're Gravie. We improve the way employers offer health benefits and provide employees coverage they can actually use.
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.