Claims Manager - Health

Claims Manager

The Senior Manager of Claims Helpdesk role is a critical role in establishing Claims Helpdesk as an area of core competence and competitive differentiation. This work will help our client scale best-in-class claims support to our ~100 companies today to ~800 companies over the next 18 months. We are looking for someone looking to bring a 10X better service experience to claims for our brokerage clients.

You will be managing and developing a high performing claims specialist team that provides timely, high-quality support to Members needing assistance during hospitalization. You will be responsible for maintenance of all claims service levels internally and in coordination with TPAs and insurers.

What you'll do :

Create a hiring pipeline for new claims specialists

Train and develop our team of claims specialists

Host daily claims huddle and weekly claims reviews with TPAs

Handle high-level claims escalations

Take ownership for claims satisfaction ratings, service levels, and maintenance of TATs with TPAs and insurers

Represent externally with current and prospective clients

Contribute to special projects with President, CRO, and COO.

Requirements :

4-8+ years of experience growing and leading teams at TPA (understanding what are the common problems a broker might face, foreseeing potential issues that we can build for, good relationships with TPAs/insurers)

Preferably a doctor

Well-established contacts with leading TPAs and insurers

Excellent written and oral communication

A medical doctor with desire to radically improve the patient's hospitalization journey

Ability to represent our claims helpdesk and performance to prospective and current clients

Data visualization skills are preferred