Who are we?
Yuzu is a tech-enabled, vertically integrated Third Party Administrator (TPA) that powers innovative health plans centered on care navigation, capitated primary care, and real-time payments. Unlike traditional TPAs, we partner closely with plan designers who serve as care navigators, contract negotiators, and sales teams for the uniquely tailored plans they create.
We currently support thousands of employees and differentiate ourselves by helping new models of healthcare delivery come to life — enabling new ways to access and pay for care through health care coverage.
Our goal is simple: make it easy for any business to build and manage a custom health plan. We do this by efficiently processing claims, ensuring regulatory compliance, and building technology that enables custom payment flows and seamless collaboration across stakeholders. Equally important, we provide our members with high-quality support to ensure they have the guidance and assistance they need at every step of their healthcare journey.
As we continue to grow, we’re excited to welcome another talented member of the Claims team to help us maintain our standard of exceptional service and innovation.
The Role:
As a Claims Resolution Specialist, you will be a key member of our growing Claims Operations Department, committed to delivering exceptional service and accurate outcomes.
In this role, you will:
Process claims in alignment with implemented plan designs
Assist the Customer Support team by responding to inquiries, supporting complex case resolution, and handling phone calls as needed
Uphold high standards for precision, accuracy, and attention to detail in every claim you handle
Proactively identify and communicate risks and opportunities within our claims processes
Help prepare and track stop loss filings to ensure continuous and timely claims payments
Play a critical role in evolving and strengthening our Claims Operations team as we scale and take on new challenges
Who We’re Looking For:
We’re seeking a motivated, ethical, and compassionate individual who thrives in a fast-paced, detail-oriented environment and is passionate about delivering fair and accurate outcomes.
If you’re passionate about doing the right thing and bringing integrity to every claim, we’d love to hear from you.
Ideal Candidates Would Possess:
Experience in healthcare claims processing, preferably within a mid-sized TPA operating in the self-funded space
A strong commitment to accuracy and attention to detail
The ability to prioritize workload effectively in a fast-paced environment
Strong communication skills
What Will Make You Stand Out:
Experience with innovative health insurance plan designs, including Reference-Based Pricing (RBP), cash payment models, and employer-sponsored Direct Primary Care
Why Join Us:
Equity opportunities
Competitive Salary
Approximately $48-$60k in annual salary depending on experience, location, and desired equity
Health benefits
401K with Employer matching
Career growth and development opportunities
Remote capabilities
We are a high-trust team with radically high transparency and autonomy
Our Interview Process:
If you’re selected for an interview, here’s what you can expect:
Initial 30–45 minute video conversation with Claims Operations Leadership
Follow-up conversation with members of the broader Operations Leadership team
Take-home assignment (approx. 2 hours) designed to reflect real on-the-job work
Reference checks with 1–2 individuals you provide
Possible onsite visit to our NYC office, depending on your location and role expectations