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Claims Resolution Advocate

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.

Yuzu is now hiring someone to help process claims for the groups that we serve and jump into complex customer support cases to help members navigate their care within the design of the health insurance plan.

We have grown to the point (>8000 covered lives) that we are ready to take on a second full-time claims professional.

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

  • You will assist the Customer Support team in to helping bridge the gap between complex customer service cases and coverage guidelines.

  • You will help prioritize feature development of our claims software.

Qualifications

  • You have to be an ethical and compassionate person.

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

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

  • You have to be comfortable working in unstructured environments.

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

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

Nice-to-haves

  • Experience with innovative health insurance plan designs including RBP, cash payment, and employer-sponsored Direct Primary Care

  • Interest in technology

Our Commitment to You

  • Competitive equity and meaningful equity in a fast-growing company

  • Approximately $65-85k 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 Russell or Tracy

  • Follow-up conversation with either Tracy 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.