护理导航员
Care Navigator
🧘 除了基本薪资之外的福利:全远程办公环境——可以全球任何地方工作我们自己的全球安全网络,提供全球范围内的健康、收入和旅行保障每年至少四周的带薪假期当需要时可获得新笔记本电脑有机会解锁股权补偿、年度家庭办公室津贴等!🚀 我们期待收到你的消息!在 SafetyWing(YC W18),我们正在为远程工作者打造一个全球性的社会安全网——简单易用的健康、保险和退休产品,旨在取代国家福利体系。我们的使命是消除地理边界对每个人平等机会和自由的阻碍。如果我们成功,我们认为这将是这个时代最重要的任务之一。 🌎 关于这个职位:我们正在寻找一名护理导航员,以支持我们美国健康保险计划的成员。我们的目标是让成员感受到被照顾,就像世界上最好的社会保障体系照顾他们的公民一样——得到保障,无需担心账单。你将使这一切成为现实:帮助成员理解他们的福利,找到高价值的院内护理,并在需要时通过申诉流程。你将成为成员与外部合作伙伴以及内部团队之间的联系人,也是当成员的计划变得复杂时他们求助的人——一份令人困惑的账单、被拒绝的索赔、关于哪些内容被覆盖的问题。你还将根据你在处理案件中观察到的索赔和成本数据中的模式,帮助我们改进产品。 💻 你的职责包括:成为成员可以交给令人困惑的账单、拒付或复杂问题的温暖而坚持的联系人当成员不知道从哪里开始时,帮助他们处理申诉流程,并在遇到复杂案例时进行审查审查费用通知单以发现任何错误并为成员争取权益协调成员与医疗机构之间解决账单和覆盖问题的全过程帮助成员和医疗机构理解哪些需要事先授权,并确保正确且及时提交,包括专科和药房的预先授权将计划设计和福利转化为通俗易懂的语言,让成员明白哪些被覆盖,哪些不被覆盖引导成员选择高价值的院内护理和医疗机构——这是行政导航,不是临床建议标记你在索赔和成本中发现的模式,以帮助我们持续改进计划 🧪 你适合这个岗位如果:
查看英文原文
🧘 Benefits beyond base pay: Fully remote work environment – work from anywhere globallyOur own global safety net, giving you worldwide health, income, and travel coverageA minimum of four weeks of vacation per yearA new laptop when you need onePotential to unlock equity compensation, yearly home office allowance and more!🚀 We look forward to hearing from you! At SafetyWing (YC W18), we’re building a global social safety net for remote workers—simple health, insurance, and retirement products designed to replace national welfare systems. Our mission is to remove geographical borders as a barrier to equal opportunity and freedom for everyone. If we succeed, we believe this will be one of the most important tasks of our time. 🌎 About this Role: We are seeking a Care Navigator to support the members on our US health insurance plan. Our goal is for members to feel taken care of the way the best social security systems in the world take care of their citizens - covered, without having to worry about their bills. You will be the person who makes that real: helping members understand their benefits, find high-value in-network care, and get through the appeals process when they need it.You'll be the connection between members and external partners, as well as internal teams, and the person a member turns to when their plan gets complicated - a confusing bill, a denied claim, a question about what's covered. You'll also help improve our product based on the patterns you notice in claims and cost data across the cases you handle.💻 Your responsibilities will include:Being the warm, persistent point of contact a member can hand a confusing bill, denial, or complex question toHelping members navigate the appeals process when they don't know where to start, and reviewing complex cases as they come upReviewing EOBs to catch any errors and advocating for the memberCoordinating between a member and their providers to resolve billing and coverage issues end to endHelping members and providers understand what requires prior authorization and making sure it's submitted correctly and on time, including specialty and pharmacy pre-authorizationTranslating plan design and benefits into plain language so members understand what is and isn't coveredPointing members toward high-value, in-network care and providers - this is administrative navigation, not clinical adviceFlagging patterns you notice in claims and costs to help us keep improving the plan 🧪 You are a good fit if you: Have several years in a medical-administrative or patient-facing coordination roleHave hands-on experience with claims, medical billing, and pre-authorizations, and can read an EOB and spot when something's offHave working familiarity with CPT and ICD coding and how charges are built and submittedAre comfortable coordinating across members, providers, and payers, with the persistence to chase something to resolutionCommunicate warmly and clearly with membersExtra shine if you have prior experience on the payer or claims-administration side of health insurance, hold a BCPA certification, or come from a clinical-adjacent background😀 We like to work with people who:Want to help build a global social safety net on the Internet.Think for themselves instead of copying others.Are willing to try new things, even with the risk of failure.Are intellectually curious and open to new ideas.Are creative and bold in the face of any problems.Have strong integrity and do the right thing.