Health Plan Operations Specialist

About the role

We are looking for additional team members to join our growing Health Plan Operations team as we scale and shape the future of health plan administration. This role is absolutely critical to the success of our company and will take on ownership for a wide range of operational workflows. We expect this team to work directly with the Founders on a regular basis.

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.

Requirements

• 6+ years of experience in health plan administration.
• Demonstrated ability to “build something out of nothing”.

Qualifications

• Experience working in health plan administration.

Skills

• Strong problem-solving skills.
• Excellent communication and customer service skills.
• Ability to manage multiple tasks simultaneously.
• Proficiency in Microsoft Office Suite.

Benefits

• Competitive benefits (medical, vision, dental).
• Unlimited PTO.
• A yearly professional development budget.

Pay

$60K - $90K

Schedule

Full-time

Location

San Francisco, CA, US / Remote (US)