Key skills
AIAnalyticsSalesforceLeadershipCommunicationNegotiation
About this role
Role Overview
- Lead and develop a high-performing Insurance and Claims Advocacy team
- Own program strategy, service delivery standards, and key performance indicators across insurance navigation and claims resolution
- Oversee resolution of complex medical billing and insurance issues
- Guide proactive insurance navigation, including benefits education, coverage guidance, and pre-service support
- Build and optimize scalable workflows, leveraging data, technology platforms, and responsible AI-enabled tools
- Ensure accurate, audit-ready documentation and adherence to SOPs, regulations, and quality standards
- Partner cross-functionally to implement improvements, support growth, and elevate the member experience
Requirements
- 7+ years of experience in medical billing/claims advocacy, complex claims resolution, appeals, coordination of benefits, and insurance plan analysis
- Bachelor’s degree in healthcare administration, business, or related field required; advanced degree and/or relevant certification preferred
- 3+ years of progressive people leadership experience
- Deep knowledge of payer claims adjudication, CPT/ICD coding, and provider billing practices
- Strong negotiation and escalation management skills
- Proven ability to drive process improvement using data/analytics, technology platforms (e.g., Salesforce, MS Office)
- Excellent communication skills and ability to influence cross-functional stakeholders
Benefits
- Generous vacation and sick time
- Market-leading paid family, parental and adoption leave
- Medical coverage
- Company paid life and AD&D insurance
- Disability programs
- Partially paid sabbatical program
- 401(k) employer match
- Stock purchase options
- Employer-funded retirement account
- Flexible, inclusive and collaborative work environment