Health Plan Operations Specialist

About TrueClaim

TrueClaim is the “Shopify for health insurance plans” - our AI-enabled platform makes operating great health plans easier and cheaper than ever before. Thanks to our claims review AI agents, TrueClaim saves health plans at least 7% of costs vs legacy solutions. We are backed by Y Combinator and other top investors, founded by industry veterans (Hinge Health, Pine Park Health - YC, pMD) and growing fast.

About the role

We are looking for additional team members to join our growing Health Plan Operations team as we scale and shape the future of health plan administration. This role is absolutely critical to the success of our company and will take on ownership for a wide range of operational workflows. We expect this team to work directly with the Founders on a regular basis.

What we think you might do:

• Handle the enrollment, eligibility, and billing processes for new and existing plan participants. 
• Manage the end-to-end process of claims, including submission, review, and payment disbursement. 
• Reconcile participant accounts to reflect claim payments, administrative payments, monthly contributions, and other plan activity
• Support members and providers via email, phone, and our app
• Conduct regular audits of data and processes to identify and resolve discrepancies, minimizing costly errors and financial risk.

What you will actually do:

• Whatever our members and customers need at any moment. As a fast growing company, we can’t guarantee that job requirements won’t evolve. If you are looking for a stable environment, and you are not feeling excited by the prospect of rolling up your sleeves to build an innovative company from the ground up, this is not a role for you.

Please avoid this role if: 

• You want to focus on strategy not operations
• You are looking for a predictable environment

Bonus points

• Experience working in health plan administration
• Demonstrated ability to “build something out of nothing”

Logistics

This is a full time role and can be remote or in person in San Francisco. We offer competitive benefits (medical, vision, dental), unlimited PTO, and a yearly professional development budget. We are intense but believe in pacing ourselves so we can make this our - and your - life’s work.