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Principal Claims Examiner

Job

Yuzu is a health insurance TPA focusing on supporting a variety of health plans designed around care navigation, capitated primary care, and real-time payments. Yuzu’s business model is different from other TPAs because we focus on supporting plan designers that themselves serve as care-navigators, contract negotiators, and salespeople for the plans they invent. Yuzu supports these plans by processing claims, performing compliance processes, and building technology to handle custom payment flows and collaboration.

We have grown to the point (>2000 covered lives) that we are ready to take on a fulltime claims adjuster. In this role

  • You will have high standards for precision, accuracy, and fairness

  • You will process claims according to new health insurance plan designs

  • You will identify and communicate risks and opportunities in our current claims processes.

  • You will help prioritize feature development of our claims software

Qualifications

  • You have to be an ethical and compassionate person.

  • You have a health insurance adjuster license or willingness to get one quickly

  • You have experience in healthcare claims processing, ideally at a mid-sized TPA in the self-funded space.

  • You have to be comfortable working in unstructured environments.

  • You have an interest in innovative healthcare financing and payment models.

  • In-person 4-5 days/week in Chelsea NYC office strongly preferred

Nice-to-haves

  • Background or aptitude in accounting and/or stoploss claims filing

  • Experience running compliance processes at TPAs

  • Interest in technology

Anti-Qualifications

  • You’d like to be hired for your connections / relationships / reputation rather than the work and insights you produce.

  • You like, believe in, or feel satisfied by the bureaucratic nature of the current healthcare administrative landscape.

  • You like meetings.

  • You like to make decisions by committee.

Our Commitment to You

  • Significant equity and competitive compensation

  • Approximately $95k-$145k in annual salary depending on equity desired and location

  • Flexible $2000/year education stipend for learning and upskilling

  • We are a high-trust team with radically high transparency and autonomy

Process

If we interview you, you can expect the following process

  • Initial 30-45 minute conversation with either Will or Russell

  • Follow-up conversation with either Will or Russell

  • A 2 hour take-home assignment designed to be similar to on-the-job work

  • An onsite interview

  • We may speak with 1-2 references you provide

Additional Reading

Apply by emailing jobs@yuzu.health or if you feel like it just call our customer support number at 203-208-9898 and ask for Russell.