Care Navigator, US Health Insurance at SafetyWing

About SafetyWing

SafetyWing (YC W18) is building a global social safety net for remote workers, offering simple health, insurance, and retirement products designed to replace national welfare systems. The mission is to remove geographical borders as a barrier to equal opportunity and freedom for everyone.

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 by helping members understand their benefits, find high value in network care, and get through the appeals process when they need it.

You will 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, whether it is a confusing bill, a denied claim, or a question about what is covered. You will also help improve our product based on the patterns you notice in claims and cost data across the cases you handle.

Responsibilities

• Be the warm, persistent point of contact a member can hand a confusing bill, denial, or complex question to
• Help members navigate the appeals process when they do not know where to start, and review complex cases as they come up
• Review EOBs to catch any errors and advocate for the member
• Coordinate between a member and their providers to resolve billing and coverage issues end to end
• Help members and providers understand what requires prior authorization and make sure it is submitted correctly and on time, including specialty and pharmacy pre authorization
• Translate plan design and benefits into plain language so members understand what is and is not covered
• Point members toward high value, in network care and providers, this is administrative navigation, not clinical advice
• Flag patterns you notice in claims and costs to help us keep improving the plan

Qualifications

• Several years in a medical administrative or patient facing coordination role
• Hands on experience with claims, medical billing, and pre authorizations, and can read an EOB and spot when something is off
• Working familiarity with CPT and ICD coding and how charges are built and submitted
• Comfortable coordinating across members, providers, and payers, with the persistence to chase something to resolution
• Communicate warmly and clearly with members
• Extra 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

Benefits

• Fully remote work environment, work from anywhere globally
• Our own global safety net, giving you worldwide health, income, and travel coverage
• A minimum of four weeks of vacation per year
• A new laptop when you need one
• Potential to unlock equity compensation, yearly home office allowance and more