TrueClaim · 3 months ago
Health Plan Operations Specialist
San Francisco, CA, US
Full-time
Hybrid
Senior Level
$60K/yr - $90K/yr
6+ years expTrueClaim is an innovative company that operates an AI-enabled platform for health insurance plans, aiming to simplify and reduce the costs of health plan administration. The Health Plan Operations Specialist will play a critical role in managing operational workflows, including enrollment, claims processing, and member support, while collaborating closely with the Founders.
Employee BenefitsHealth CareHealth Insurance
Responsibilities
Handle the enrollment, eligibility, and billing processes for new and existing plan participants
Manage the end-to-end process of claims, including submission, review, and payment disbursement
Reconcile participant accounts to reflect claim payments, administrative payments, monthly contributions, and other plan activity
Support members and providers via email, phone, and our app
Conduct regular audits of data and processes to identify and resolve discrepancies, minimizing costly errors and financial risk
Whatever our members and customers need at any moment. As a fast growing company, we can’t guarantee that job requirements won’t evolve. If you are looking for a stable environment, and you are not feeling excited by the prospect of rolling up your sleeves to build an innovative company from the ground up, this is not a role for you
Qualification
Required
6+ years of experience in operations
Ability to handle enrollment, eligibility, and billing processes for new and existing plan participants
Experience managing the end-to-end process of claims, including submission, review, and payment disbursement
Ability to reconcile participant accounts to reflect claim payments, administrative payments, monthly contributions, and other plan activity
Experience supporting members and providers via email, phone, and app
Ability to conduct regular audits of data and processes to identify and resolve discrepancies, minimizing costly errors and financial risk
Willingness to adapt to evolving job requirements in a fast-growing company
Preferred
Experience working in health plan administration
Demonstrated ability to 'build something out of nothing'
Benefits
Competitive benefits (medical, vision, dental)
Unlimited PTO
Yearly professional development budget
Company
TrueClaim
Maximizing healthcare benefits for self-insured employers.
2-10 employees
Funding
Current Stage
Early StageTotal Funding
$2.1MKey Investors
Y Combinator
2024-02-27Pre Seed· $2.1M
Recent News
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