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Salary: USD 58,000 - 82,000 / annual
Devoted Health is seeking a Senior Associate for Member Claim Processing to lead operational execution of member claim processing for its Medicare Advantage business. Reporting to the Associate Director of Claims Operations, you will own the end-to-end member claim processing function, ensuring claims are processed accurately, timely, and in compliance with regulatory requirements while maintaining member trust.
Key responsibilities include:
- Own day-to-day operational execution of member claim processing, personally handling complex, escalated, and non-standard claims outside routine adjudication
- Manage member claim timeliness for your queue by monitoring inventory, aging, and turnaround time against service level requirements
- Identify and clear bottlenecks before they become compliance risks; escalate risks to management
- Adhere to all standard operating procedures and escalate complex scenarios requiring clarification
- Partner with Claims Operations, Configuration, and Tech leadership to identify root causes of processing errors and rework, providing feedback loops to prevent defects
- Support processing of member claim appeals and member claim cases
This role sits at the intersection of operations, compliance, and member experience. You will work in a fast-paced healthcare technology environment, balancing high throughput with accuracy and attention to detail.
Required qualifications:
- Bachelor's degree or equivalent work experience
- Exceptional organizational skills with strong attention to detail
- Operations-minded approach to processing claims accurately and quickly
- Strong communication skills with ability to reframe conversations and condense complex concepts into clear, simple explanations
- Strong writing ability to craft clear, plain-language communications tailored to member needs
- Track record of building and maintaining process documentation that is clear, repeatable, and audit-ready
Desired qualifications:
- Experience in healthcare, healthcare technology, or tech operations
- Experience with Medicare Advantage claims adjudication, member reimbursement, or CMS timeliness requirements
- Proven ability to thrive in a fast-paced startup environment
- Capacity for high throughput while working autonomously and collaboratively
- Track record of becoming an expert with unfamiliar tools or systems
- Experience with data, analytics, and business intelligence platforms such as Snowflake or Looker
