Senior Member Claims Processing Leader

Devoted Health Services, Inc; Waltham (MA); On-site; USD 58,000 - 82,000; Full time

Benefits offered by this job

Health, dental and vision plan

Generous paid time off

$100 monthly mobile/internet stipend

Stock options

Bonus eligibility for most roles

Parental leave

401K

Job summary

The Sr. Associate, Member Claim Processing at Devoted Health leads the operation of member claim processing for our Medicare Advantage business. You own processing for submitted claims, ensuring accuracy, timeliness, and member trust.

You’ll collaborate across Claims Operations, Configuration, and Tech to reduce errors and improve processes. You’ll handle complex and escalated claims, monitor queues to meet service levels, and contribute to a compliant, high‑quality member experience.

Qualifications

• Organization skills with attention to detail and documentation
• Operations minded with ability to process claims accurately and quickly
• Strong written and verbal communication; can simplify complex concepts
• Excellent writing to craft clear, plain-language member communications
• Experience building and maintaining process documentation for audit readiness
• Bachelor's degree or equivalent work experience

Responsibilities

• Own day-to-day operational execution of member claim processing, including complex/escalted/non-standard claims
• Monitor queue timeliness, aging, and turnaround against service levels
• Identify and clear bottlenecks to mitigate compliance risk; escalate when needed
• Follow SOPs; clarify complex scenarios to ensure processing accuracy
• Partner with Claims Operations, Configuration, and Tech to feedback root causes of errors
• Support processing member claim appeals and claims cases

Skills

Organization

Operations focus

Communication

Writing

Process docs

Bachelor's degree

Education

Bachelor's degree or equivalent

Tools

Snowflake/Looker

Job description

The Sr. Associate, Member Claim Processing at Devoted Health leads the operation of member claim processing for our Medicare Advantage business. You own processing for submitted claims, ensuring accuracy, timeliness, and member trust.

You’ll collaborate across Claims Operations, Configuration, and Tech to reduce errors and improve processes. You’ll handle complex and escalated claims, monitor queues to meet service levels, and contribute to a compliant, high‑quality member experience.