Care Navigator

Accountabilities:: In this role, you will help members understand their health insurance coverage, resolve administrative challenges, and access appropriate in-network care. You will combine strong coordination skills with persistence, clear communication, and attention to detail. Serve as a warm, reliable point of contact for members facing confusing medical bills, denied claims, coverage questions, or other complex insurance issues. Guide members through the appeals process, helping them understand their options and reviewing complex cases when needed. Review Explanation of Benefits (EOB) statements to identify potential errors and advocate for members when discrepancies arise. Coordinate with members and healthcare providers to resolve billing and coverage issues from initial inquiry through final resolution. Explain prior authorization requirements to members and providers, ensuring submissions are accurate and completed on time, including specialty care and pharmacy pre-authorizations. Translate insurance plan structures, coverage rules, and benefits into clear, practical explanations. Help members identify high-value, in-network providers and care options, focusing on administrative navigation rather than clinical advice. Identify recurring patterns in claims, billing issues, and healthcare costs, sharing insights that can support improvements to the insurance plan and member experience. Requirements: The ideal candidate brings hands-on experience in medical administration, patient coordination, or health insurance operations, along with the ability to navigate complex billing and claims processes. You should be empathetic, resourceful, and comfortable following up with multiple stakeholders until an issue is resolved. Several years of experience in a medical-administrative, patient-facing, or healthcare coordination role. Practical experience with medical claims, billing, and prior authorizations. Ability to interpret EOB statements, identify potential billing or coverage errors, and determine when further investigation is needed. Working knowledge of CPT and ICD coding, including how medical charges are structured and submitted. Experience coordinating between patients or members, healthcare providers, and insurance payers. Strong follow-through and problem-solving skills, with the persistence to manage cases through to resolution. Excellent communication skills and the ability to explain complex insurance information clearly and compassionately. Intellectual curiosity, creativity, independent thinking, adaptability, and a willingness to test new approaches. Strong integrity and a commitment to doing the right thing for members. A genuine interest in building a more accessible, global social safety net. Additional advantages include experience on the health insurance payer or claims-administration side, a BCPA certification, or a clinical-adjacent professional background. Benefits: Fully remote working environment, with the flexibility to work from anywhere globally. Access to worldwide health, income, and travel coverage through the company's own global safety net. A minimum of four weeks of paid vacation per year. A new laptop when needed to support your work. Potential eligibility for equity compensation. Annual home office allowance. Permanent, full-time employment. The opportunity to contribute to a global mission focused on improving access to healthcare and financial protection for remote workers.