Director – Claims Operations
Posted on 2/13/2024
Sana

201-500 employees

Small business employee benefits platform
Company Overview
Sana's mission is to make quality healthcare understandable, accessible and affordable for all. Sana helps small businesses offer high-quality benefits, save on healthcare costs, and avoid expensive employee turnover.
B2C

Company Stage

Series B

Total Funding

$109.2M

Founded

2017

Headquarters

Austin, Texas

Growth & Insights
Headcount

6 month growth

-2%

1 year growth

-5%

2 year growth

30%
Locations
Remote
Experience Level
Entry
Junior
Mid
Senior
Expert
Desired Skills
Communications
SQL
Tableau
JIRA
CategoriesNew
Operations & Logistics
Requirements
  • 6+ years of relevant medical claims operations experience
  • Working knowledge of healthcare billing regulations, compliance requirements, and industry trends
  • Experience with SQL, Excel/Sheets, and business intelligence tools such as Tableau or Mode
  • Experience with software like Jira, Zendesk, Visium, etc.
  • Strong written and verbal communication skills
  • Ability to multitask and prioritize business requirements in a dynamic, fast-paced environment
Responsibilities
  • Lead and grow a team of Claims Processors, Claims Analysts, and Managers
  • Ensure accurate and timely payment of medical claims and balance bill settlements
  • Develop plans for team members’ career growth through coaching and feedback sessions
  • Collaborate with Product leadership and engineers to support system development
  • Ensure compliance with state and federal regulations
  • Own partner relationships including claims intake, pricing, payment disbursements, and dispute resolution
  • Create and monitor key performance indicators using SQL-backed business intelligence tools
  • Be accountable for quarterly and annual goals aligned with company targets
  • Act as the Claims Operations cross-functional leader and partner to other teams
Desired Qualifications
  • Experience with vendors in the provider payment space (e.g. ECHO), third-party claims clearinghouses, FAIR Health, etc.
  • Values-oriented and cares deeply about making the healthcare system work better for people and businesses
  • Willingness to jump into any of the team’s work and support
  • Comfortable in challenging the processes and approaches taken by legacy carriers
  • Appreciation and respect for the diversity of thoughts and skills within the team