Claims Processor (f/m/x) Berlin

September 13, 2024

Apryl

Berlin

We’re Apryl, part of the Progyny Inc family.

Our shared mission? To make fertility and family-forming care accessible everywhere, breaking down barriers so that anyone can start a family, no matter where they are. With Progyny's support, we're set to amplify our impact globally, reaching more individuals and families than ever before.

Our goal is to simplify the claims process for our members, transforming it from a challenging task to a seamless experience. We are looking for a detail-oriented and diligent Claims Expert to join our team.

Tasks

In this role, you will be responsible for reviewing incoming member out-of-pocket expenses. You will collaborate with the Member Care and Finance team to ensure an exceptional member experience.

Claims Processing: Manage incoming claims in our claims management system, ensuring all information is accurate and up-to-date.
Member and Provider Communication: Communicate with members and providers regarding missing or unclear information and provide timely updates on claim status. Liaise with internal teams to resolve escalated claim issues and manage inquiries received via the Claims inbox.
Claims Validation: Review and validate claims for accuracy and completeness, process awards in accordance with company policies, and resolve claim reprocessing and authorization issues.
Quality Assurance & Compliance: Conduct regular quality checks, audits, and review reports to ensure claims comply with internal policies and external regulations. Maintain thorough knowledge of processing requirements for each plan.
Case Management: Ensure timely resolution of open claims and inquiries. Schedule weekly/biweekly calls to address claim status, denial reasons, and reprocessing issues.
Process Optimization: Identify opportunities to enhance productivity and streamline claims processing workflows, recommending and implementing improvements as needed.

Requirements

Experienced in processing claims and maintaining high accuracy
Highly detail-oriented and organized
Structured thinker
Excellent verbal and written communication skills
Problem-solving skills to analyze, troubleshoot and resolve issues
Proficiency with Microsoft Excel / claims management systems
This position requires on-site presence in our Berlin office
You are eligible to work within the EU

It would be nice if you have

Previous experience in customer service (Healthcare / Insurance)
Bachelor’s degree in business, insurance, healthcare or equivalent

Benefits

Annual gross salary range for Berlin-based applicants: €50,000-55,000
Bonus program and company equity
Fertility & family building benefit: Get access to our Apryl Platform and a 5.000€ benefit budget
Mental health benefit: Access to 1:1 sessions with experienced psychologists & in-app training & tools from Nilo Health
Sustainable mobility benefit: Dance e-bike subscription or monthly public transportation ticket (BVG)
Hybrid work: Up to 2 days a week work from home
Remote work: Up to 8 weeks per year

We believe in equal opportunities. We celebrate diversity and are committed to creating an inclusive environment for all employees.

If you're passionate about helping others and want to make a difference in people's fertility and family-forming journeys, we encourage you to apply and join our mission at Apryl.

We regret to inform you that this job opportunity is no longer available