Health Plan Operations Specialist
Hybrid (San Francisco, CA)$60k - $90kFull-timePosted 11mo ago
About the role
Role within TrueClaim's Health Plan Operations team focusing on enrollment, eligibility, billing, claims processing, data reconciliation, and member/provider support to scale health plan administration.
Responsibilities
- Handle the enrollment, eligibility, and billing processes for new and existing plan participants.
- Manage the end-to-end process of claims, including submission, review, and payment disbursement.
- Reconcile participant accounts to reflect claim payments, administrative payments, monthly contributions, and other plan activity
- Support members and providers via email, phone, and our app
- Conduct regular audits of data and processes to identify and resolve discrepancies, minimizing costly errors and financial risk.
Qualifications
- 6+ years of experience in related operations roles or equivalent.
Skills
Required:Enrollment processingClaims processingAccount reconciliation
Benefits
- competitive benefits (medical, vision, dental)
- unlimited PTO
- yearly professional development budget
Last updated Oct 14, 2026. Interested? Apply on the company site.
About TrueClaim
Transparent, AI-powered healthcare TPA.
TrueClaim processes all payments between healthcare providers and companies that self-fund their insurance. TrueClaim's AI-enabled engine adjudicates and continuously reviews 100% of medical claims to save at least 7% of healthcare costs.
More open roles at TrueClaim
- Founding Product Engineer1w agoHybrid (San Francisco, CA)
- Solutions Engineer6mo agoHybrid (San Francisco, CA) · Engineering