Claims Processor

2 нед. назад

USA

Responsible for adjudicating member out-of-pocket expenses, supporting eligibility checks, tracking claims life cycle, and reviewing transactions with Carrot Card.

Обязанности

You'll report to our Manager, Payments, and support Carrot’s existing members and internal business partners to ensure the best possible experience. In this role, you will be responsible for adjudicating member out-of-pocket expenses, supporting eligibility checks, tracking the life cycle of claims, and reviewing member transactions incurred using the Carrot Card. You will collaborate and cross-functionally work with other teams in the organization to ensure that payment for applicable care is quickly and accurately facilitated. This role will respond in a timely manner to member needs, questions, and requests pertaining to their claims. Additionally, this role requires a tech-savvy, process-oriented person with superb written communication skills and an interest in furthering Carrot’s mis
This is an onsite position in West Des Moines, IA. The schedule is Monday-Friday from 10:00 am to 7:00 pm CST. Training will take place over the first 4-6 weeks, between the hours of 8:00 am and 7:00 pm CST.

Требования

You likely have:
Bachelor’s degree (required)
Availability to work Monday through Friday between the hours of 10AM-7PM CST
Adaptable to a fast-paced, ever changing work environment with an ability to continually learn, obtain information, and retain information essential to helping members
Highly detail-oriented with superior multi-tasking skills
Ability to work independently with little management or direction on routine duties or projects
Exceptional verbal and written communication skills with an ability to empathetically support a diverse member population
Strong problem-solving skills to analyze, troubleshoot and resolve issues

Будет плюсом

While not required, we would be especially excited if you bring:
Knowledge with insurance regulations and industry best practices
Experience working at a fast-growing tech company or digital health company
Proficiency and comfort using business tools (e.g., Jira, Confluence, Zendesk, Airtable, G-Suite)

Как откликнуться

We believe in a thoughtful and transparent interview process designed to create alignment for both candidates and our team.
For this role, candidates can expect:
Recruiter Screen — 30 minutes
Hiring Manager Interview — 30 minutes
Take-Home Performance Task — 20 minutes
Leadership Conversation — 30 minutes
  Throughout the process, we will share additional context about the team, business priorities, customer landscape, and what success looks like in this role.

Другое

Carrot is the leading global fertility and family care platform, built on intelligent care orchestration: the right clinical guidance, at the right moment, in the context of each member’s life. More than a thousand multinational employers, health plans, and health systems trust Carrot to support millions of members across 195 countries – from pre-pregnancy through menopause and major life moments in between. Carrot's comprehensive clinical program delivers industry-leading cost savings for plan sponsors and award-winning experiences and improved outcomes for millions of people worldwide. Carrot is widely regarded as a defining force in healthcare innovation as a recipient of several top-tier awards, including Fast Company's 'Most Innovative Companies' and CNBC's '100 Barrier Breaking Start
In this role, you will:
Process 53+ claims each working day, maintaining a quality assurance score of 93% or higher
Promptly and empathetically attend to member questions 
Support both US and non-complex global claims, including Carrot Card transactions
Provide direct support on post-adjudication impacts to claims (ex: Refunds, Reconciliations, Adjustments)
Provide on-call member support via Pagerduty as needed
 
In your first 12–18 months, you will have:
Consistently processed claims accurately, efficiently, and in accordance with plan guidelines and established procedures.
Build strong working knowledge of our benefit, systems, workflows, and quality standards.
Meet or exceed role-specific productivity, turnaround-time, and quality expectations.
Resolve member and partner questions with professionalism, empathy, and clear communication.
Identify potential errors, missing information, and process issues before they create unnecessary delays.
Demonstrate sound judgment when escalating complex or unusual claims for additional review.
Contribute ideas that improve the claims experience, reduce rework, and strengthen team efficiency.
Become a trusted teammate who supports a reliable, fair, and positive experience for every member.
 
As a Claims Processor, you play a critical role in helping members access their Carrot benefit. By reviewing claims accurately, applying plan guidelines consistently, and resolving questions with care and empathy, you’ll help deliver a fair, timely, and dependable claims experience.
Your attention to detail will make a meaningful difference for every person who submits a claim. You’ll help reduce delays, prevent errors, protect the integrity of the claims experience, and ensure payments are processed smoothly. This is an opportunity to build trust through thoughtful service while contributing to a high-quality experience for members and partners.
 
Carrot offers the opportunity to do meaningful work in service of a deeply human mission.
Highlights include:
A mission-driven company focused on expanding access to fertility and family-forming care globally.
A high-growth environment where leaders are empowered to shape strategy and drive impact.
Competitive compensation, equity, and comprehensive benefits.
Flexible Time Off and a culture that actively encourages employees to recharge.
Comprehensive parental leave and family-forming benefits.
A collaborative, inclusive, and values-driven culture.
The opportunity to work alongside passionate, thoughtful teammates committed to improving healthcare outcomes worldwide.
 
Compensation 💰
Carrot offers a holistic, total rewards package designed to support our employees in all aspects of their life inside and outside of work, including health and wellness benefits, retirement savings plans, short- and long-term incentives, paid time off, sick time, parental leave, family-forming assistance, and a competitive compensation package. This is a non-exempt position with a base pay of $24.00-$28.00 per hour, plus a variable. In addition, this role may include variable compensation based on performance. Overtime pay will apply when required, and paid overtime may be necessary during peak periods. The actual rate of pay will be determined based on job-related skills and experience.
 
Fraud and Security Notice: Please note that all communication regarding job opportunities at Carrot will come exclusively from an @ email address. If you receive messages from any other domain, please disregard them and report the incident to: securityreporting@
 
At Carrot, we believe AI can help us work smarter, move faster, and create more meaningful experiences for our members, customers, and each other. While not every role requires deep technical AI expertise, we value people who are curious, eager to learn, and excited to thoughtfully incorporate AI into their day-to-day work.
For some roles, AI fluency is a core requirement—and we'll call that out clearly in the qualifications. For everyone else, we're looking for people who embrace new ways of working, use AI responsibly to improve quality and efficiency, and continue to learn as the technology evolves.
Carrot has received national and international recognition for its pioneering work, including Fast Company's Most Innovative Companies and World Changing Ideas, Inc. Power Partners, and Modern Healthcare’s Innovators. Carrot’s global workforce has been acknowledged with several accolades, including Fortune’s Best Workplaces in Healthcare, Great Place to Work, and Age-Friendly Employer certifications. Carrot is regularly featured in media reporting on issues related to the future of work, women in leadership, and healthcare innovation, including MSNBC, The Economist, Bloomberg, The Wall Street Journal, CNBC, National Public Radio, Harvard Business Review, and more. Learn more at .com.