The Role
Modern Health is looking to add a Health Plan Operations Associate to our team. In this role, you will help us maintain foundational systems and processes to support all aspects of health plan integration: member health plan eligibility checks, medical claim submissions, claim tracking, member payments, and other areas. This role reports to the Health Plan Operations Senior Manager.
This position is open to candidates residing in AL, AZ, AR, CT, DE, FL, GA, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WV, WI, WY.
What You’ll Do
- Track claims and denials through the entire claim lifecycle
- Manage and establish new systems to support claims processing and related areas
- Identify gaps in claims and reach out to providers for missing information
- Help members troubleshoot issues involving claims or eligibility
- Create documentation and training materials for the broader Ops team
- Provide reporting and other visibility into this function
- Complete other special projects as needed
Who You Are
- You have 1-2 years of relevant work experience (claims experience is a plus)
- You are highly detail-oriented and organized
- You are a structured thinker and love checking things off your to-do list
- You have excellent verbal and written communication skills
- You are a problem solver and are able to analyze, troubleshoot and resolve issues
- You enjoy working with different kinds of people and are great at building relationships
- You are a team player who enjoys identifying group pain points and improving them
- You are humble, scrappy, and thrive in fast-paced environments
Benefits
Fundamentals:
- Medical / Dental / Vision / Disability / Life Insurance
- High Deductible Health Plan with Health Savings Account (HSA) option
- Flexible Spending Account (FSA)
- Access to coaches and therapists through Modern Health's platform
- Generous Time Off
- Company-wide Collective Pause Days
Family Support:
- Parental Leave Policy
- Family Forming Benefit through Carrot
- Family Assistance Benefit through UrbanSitter
Professional Development:
- Professional Development Stipend
Financial Wellness:
- 401k
- Financial Planning Benefit through Origin
But wait there’s more…!
- Annual Wellness Stipend to use on items that promote your overall well being
- New Hire Stipend to help cover work-from-home setup costs
- ModSquad Community: Virtual events like active ERGs, holiday themed activities, team-building events and more
- Monthly Cell Phone Reimbursement
