Senior Member Claim Processor — Medicare Advantage Ops

devoted; United States; À distance; USD 58 000 - 82 000; Plein temps

Avantages offerts par ce poste

Health, dental and vision coverage

Generous paid time off

Mobile/internet stipend

Stock options

Bonus eligibility for most roles

Parental leave

401K plan

Résumé du poste

Devoted Health seeks a Sr. Associate, Member Claim Processing to own day-to-day processing of member claims for our Medicare Advantage program, ensuring accuracy, timeliness, and trust with members.

You will report to the Associate Director, Claims Operations and operate at the intersection of operations, compliance, and member experience. Responsibilities include handling complex claims, managing timeliness metrics, adhering to SOPs, partnering with Claims Ops, Configuration, and Tech, and

Qualifications

• Bachelor's degree or equivalent work experience.
• Strong organization skills and attention to detail.
• Ability to process claims accurately and quickly.
• Excellent written and verbal communication; ability to simplify complex concepts.

Responsabilités

• Own day-to-day execution of member claim processing, handling complex and escalated claims.
• Manage timeliness, queue inventory, aging, and turnaround against service levels.
• Follow SOPs and escalate unclear cases to ensure processing accuracy.
• Collaborate with Claims Operations, Configuration, and Tech to reduce defects.
• Support processing member claim appeals and related cases.

Connaissances

Organization skills

Operations mindset

Communication skills

Writing skills

Process documentation

Formation

Bachelor's degree or equivalent

Outils

Snowflake

Looker

Description du poste

Devoted Health seeks a Sr. Associate, Member Claim Processing to own day-to-day processing of member claims for our Medicare Advantage program, ensuring accuracy, timeliness, and trust with members.

You will report to the Associate Director, Claims Operations and operate at the intersection of operations, compliance, and member experience. Responsibilities include handling complex claims, managing timeliness metrics, adhering to SOPs, partnering with Claims Ops, Configuration, and Tech, and