At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

Job Description

A bit about this role:

At Devoted, we know that one of the most important ways we will build trust is by ensuring we can pay claims accurately and on time, while providing the strategic flexibility to change payment models. Our Claims Operations team is responsible for managing claims processing and payment along with all post adjudication work. Devoted has built a team of people, effective processes and proprietary technology that delivers industry leading claims payment, accuracy and provider satisfaction. Devoted Health has built the core technology platform from the ground up. The claims associate will use a variety of systems and tools to ensure workflows, processes and system configurations are executed accurately. The claims associate will work collaboratively with different parts of the organization to ensure we are continuously improving our people, processes and technology. The successful candidate will be one of a few Medicare claim experts at Devoted. Our strategy is to stand up programs/processes within the US team, improve and evolve them to the point where they can either be automated or outsourced to our global staffing partners.

Responsibilities will include:

• 75% of the time will be spent working on complex production tasks including but not limited to provider disputes, case resolution, Direct member reimbursement, provider support.

  • The type of work being managed will change as we grow and develop

  • You will be responsible for meeting productivity goals that will change as the type of work changes

• 25% of time will be spent working on a number of projects such as root cause analysis developing standard operating procedures (SOPs), developing new programs

• Holds self accountable for complying with policies, procedures, and work requirements

• Work with cross functional teams to develop, implement or improve workflows

• Performs in depth analysis of complex claims to determine root cause analysis and process improvements

• Functions as a subject matter expert within all claims areas

• Assist and lead meetings with other teams and provider groups

• Works with other teams to resolve complex challenges and to support our members and providers

• Shares learned experiences with the organization

• Identify and implement creative process improvement (must be excited to roll up your sleeves and make things better!)

• Understand and adhere to complex regulations and developing policies and procedures

• Other ad-hoc tasks as assigned

• Potential opportunities for travel

Attributes to success:

• Makes independent decisions on day to day work based on standard procedures and professional experience

• Executes work/projects to achieve goals

• Stays up to date with job specific knowledge and systems

• Conveys ideas clearly and in a way that engages others

• Attention to detail

• Adhere to production requirements

• Independent & Innovative thinker

• Problem Solver

• Curiosity and willingness to ask questions

• Perform oversight of claims programs

• Team player willing to do the hard work

• You will roll up your sleeves and do whatever it takes to get the job done

• Eager to learn and initiate conversations to improve the overall claims experience

• A deep desire to improve and make a change in the healthcare experience

• Preference towards collaboration and preventing silos

• Ability to work through challenges with an open mind and positive attitude

Required skills and experience:

• 3 - 5 years claims experience within a Managed Care Organization, preferable Medicare Advantage

• Ability to research across internal and external resources

• Knowledge and understanding of Medicare regulations

• Strong analytical skills and ability to work in spreadsheets

• Strong written and verbal communication skills

#LI-DS1
#LI-Remote

Salary Range: $23 - $38 per hour

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium

• Generous paid time off

• $100 monthly mobile or internet stipend

• Stock options for all employees

• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

• Parental leave program

• 401K program

• And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity).

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.