Health claims lead (f/m/x)

What you bring to the table

• You have hands-on experience handling health claims across borders or internationally.
• You are familiar with medical coding and provider billing.
• You have an instinct for automation and AI tooling, and you use it daily.
• You take tough decisions daily, including saying no to customers, and you still enjoy the work.
• You are pragmatic in an unfinished system: you improve it while running it.
• You are a fluent English speaker.

Nice to have:

• German, Spanish, or French language skills.
• Experience with moratorium underwriting.
• A medical background.
• Experience in an MGA or delegated authority setup.
• Experience managing third-party administrators (TPAs).

You'll be responsible for

• You will make claims decisions
• You will interpret coverage, decide declines, settlement amounts, and goodwill within policy terms, with real authority, not recommend-and-wait.
• You will handle expat and international health claims: cross-border invoices across languages and billing conventions, currency and tax, and coordination with statutory and private cover in the country of residence.
• You will manage our carrier relationships
• You will own claims reporting and bordereaux, contentious cases, and coverage disputes with our insurance partners.
• You will keep audit-ready records throughout, so nothing surprises the carrier.
• You will decide how we work with service providers
• You will decide where using third-party administrators (TPAs) makes sense, and manage instructions, quality, turnaround, and commercial performance where we use them.
• You will build the operating model
• You will close gaps with product and engineering across intake, documents, decision support, payout, and automation.
• You will run audits and fraud checks, working toward semi-automated monitoring with the data team.
• You will build capability
• You will write the playbook so health claims stops depending on one person.
• You will train whoever joins the team next.

What will the interview process look like?

• CV screening
• Initial phone call with our People team. We'll have a chat and get to know each other (30m)
• Hiring manager call. We'll cover the role, skills needed, and answer your questions (1 hour)
• Case study. We'll give you a case study to work on, which will give you an idea of the type of projects you'd take on at Feather (3-4h)
• Case study discussion. We'll go through your reasoning and approach together (90min)
• Call with our Head of Ops. We'll talk through our async, remote-first way of working and how our team operates day to day (45min)
• Final interview. You'll be speaking to one member of our leadership team (45min)

Does this sound like a good fit for you? Apply now!

At Feather, we actively foster inclusive representation within our teams and embrace a diverse mix of talent. We encourage applicants from all educational paths to apply: we believe that what you’ve built, worked on, and achieved is far more important than on-paper qualifications.

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Mostramos trecho e link por vaga, e o texto integral quando a fonte permite. Marcas e logotipos citados pertencem aos seus titulares.

Fonte: Statistisches Bundesamt (Destatis), tabela; dl-de/by-2-0; cálculo da StarIn