Claims Resolution Specialist

πŸ”₯ 1 hour ago

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Yuzu

51 - 200 employees

Founded 2022

πŸ₯ Healthcare

πŸ›‘οΈ Insurance

☁️ SaaS

Healthcare β€’ Insurance β€’ SaaS

Yuzu is a technology platform that lets organizations design, launch, and operate custom health plans and modernize third-party administrator (TPA) workflows. It provides a Benefits Builder to configure tiers, accumulators, and benefits; integrations with PBMs, stop-loss carriers, and other vendors; automated document generation and e-signature; web-based portals for employers, members, and vendors; in-house claims adjudication and payment infrastructure with real-time auto-ledgering; and reporting and support tools. Yuzu emphasizes white-labeling so customers can present fully branded plans and handles end-to-end plan operations from onboarding to live plan management.

πŸ“‹ Description

β€’ Process claims in alignment with implemented plan designs β€’ Assist the Customer Support team by responding to inquiries, supporting complex case resolution, and handling phone calls as needed β€’ Uphold high standards for precision, accuracy, and attention to detail in every claim you handle β€’ Proactively identify and communicate risks and opportunities within our claims processes β€’ Help prepare and track stop loss filings to ensure continuous and timely claims payments β€’ Play a critical role in evolving and strengthening our Claims Operations team as we scale and take on new challenges

🎯 Requirements

β€’ Experience in healthcare claims processing, preferably within a mid-sized TPA operating in the self-funded space β€’ A strong commitment to accuracy and attention to detail β€’ The ability to prioritize workload effectively in a fast-paced environment β€’ Strong communication skills

πŸ–οΈ Benefits

β€’ Equity opportunities β€’ Competitive Salary β€’ Health benefits β€’ 401K with Employer matching β€’ Career growth and development opportunities β€’ Remote capabilities β€’ We are a high-trust team with radically high transparency and autonomy

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