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Summary:
- Be a part of the team building the future of healthcare.
- Firefly Health is building a revolutionary new type of comprehensive health “care and coverage,” powered by a relationship-driven care team, a trusted virtual and in-person clinical network, and a proprietary technology platform.
- Founded by experienced clinicians and technology leaders, Firefly Health is on a mission to deliver clinical and financial health through joyful, always-there care.
- The company is focused on optimizing the physical, mental, and financial wellbeing of those who want something better than the status quo.
Responsibilities:
- Claims Inquiry Management: Capture, document, and triage member and provider claims inquiries. Investigate and resolve claims issues within SLA, ensuring accurate and timely communication to stakeholders. Serve as a point of contact for escalations, ensuring satisfactory resolution and a positive customer experience.
- Customer Experience Excellence: Maintain a high standard of professionalism and empathy in all interactions with members and providers. Proactively follow up on outstanding issues to ensure resolution and satisfaction.
- Process and Technology Improvement: Analyze trends in inbound inquiries to identify root causes and recommend process improvements. Partner with cross-functional teams to implement solutions that reduce inquiry volume and improve workflows. Provide feedback to enhance tools and systems used for claims management.
- Collaboration and Reporting: Work closely with internal teams to escalate and resolve complex issues. Prepare regular reports on inquiry resolution metrics and performance against SLAs.
Requirements:
- Experience: Minimum of 2 years of experience working with health plans or in a similar role involving claims management.
- Skills: Exceptional attention to detail, ensuring accuracy in capturing and resolving claims inquiries. Strong problem-solving skills and a bias towards taking initiative and action. Curiosity to understand the root causes of issues and a passion for continuous improvement. Excellent communication skills, both written and verbal, with the ability to convey complex information clearly. Proficiency with claims systems and a strong aptitude for learning new tools and technologies. Ownership mentality, with the ability to see tasks through to completion independently. A customer-first approach, with a dedication to providing a superior experience for members and providers. Adaptability and willingness to thrive in a fast-paced, dynamic environment.
- Nice to Have: Familiarity with common health plan operations & terms, including claims adjudication, member services, or provider relations. Experience working with process improvement initiatives, such as Lean or Six Sigma methodologies. Comfortable working with Google Work products including Gmail, Google Sheets, Google Slides, Looker, and Google Drive. SQL and data analysis experience preferred.
Benefits:
- Time off: Flexible paid vacations and many other observed holidays by country, including a day off for special days like birthdays and work anniversaries.
- Flexible Working: Flexible work arrangements that accommodate working styles and personal life.
- Medical Benefits: Health insurance coverage for employees and dependents.
- Mental Health and Wellness: Wellness Wednesdays and well-being coaching to promote mental and physical health.
- Learning & Development: Support for self-learning L&D allowances.
- Tech Support: Provision of company laptop and support for high productivity tools and equipment.
