Care Navigator

This is a fully remote position, open to applicants anywhere in the world.

📋 Description

• Act as a warm and dedicated contact for members facing confusing bills, denials, or complex inquiries.

• Assist members in navigating the appeals process and analyzing intricate cases.

• Examine EOBs to identify discrepancies and advocate on behalf of members.

• Facilitate coordination between members and providers to address billing and coverage concerns comprehensively.

• Aid members and providers in understanding prior authorization requirements, ensuring that submissions are accurate and timely, including specialty and pharmacy pre-authorizations.

• Simplify plan design and benefits into easily understandable language.

• Guide members towards high-value, in-network care and providers through effective administrative navigation.

• Identify patterns in claims and costs to assist in plan enhancements.

• Connect members with external partners and internal teams.

⛳️ Requirements

• Possess several years of experience in a medical-administrative or patient-facing coordination role.

• Have practical experience with claims, medical billing, and pre-authorizations, with the ability to read an EOB and identify discrepancies.

• Familiarity with CPT and ICD coding, along with an understanding of how charges are generated and submitted.

• Comfortably coordinate among members, providers, and payers, demonstrating persistence in pursuing resolutions.

• Communicate warmly and effectively with members.

• Additional consideration for candidates with prior experience in the payer or claims-administration side of health insurance, a BCPA certification, or a clinical-adjacent background.

• Desire to contribute to building a global social safety net on the Internet.

• Ability to think independently rather than just replicating others’ ideas.

• Willingness to experiment with new approaches, even at the risk of failure.

• Display intellectual curiosity and openness to new concepts.

• Be creative and courageous when tackling challenges.

• Uphold strong integrity and consistently do the right thing.

🏝️ Benefits

• Fully remote work environment – work from anywhere in the world.

• Access to our global safety net, providing you with worldwide health, income, and travel coverage.

• A minimum of four weeks of vacation each year.

• A new laptop available when needed.

• Opportunity to earn equity compensation, an annual home office allowance, and more!