Health claims lead

About the role

As the Health Claims Lead, you will own claims decisions for health MGA books, including coverage, declines, and settlement amounts. You will manage insurance carrier relationships, oversee service provider partnerships, and build the systems and playbooks necessary to scale health claims operations for international and expat insurance products.

Responsibilities

• Make claims decisions regarding coverage, declines, and settlement amounts within policy terms.
• Handle international and expat health claims, including cross-border invoices and coordination with private and statutory cover.
• Manage insurance carrier relationships, including claims reporting, bordereaux, and coverage disputes.
• Decide on the use of third-party administrators and manage their commercial performance and quality.
• Collaborate with product and engineering teams to build the operating model, including automation and decision support.
• Develop the claims playbook and train future team members.

Required skills

• Health claims
• Insurance
• Medical coding
• Provider billing
• Automation
• AI tooling

Nice to have

• Moratorium underwriting
• MGA
• Delegated authority
• TPA management
• German
• Spanish
• French

About the Company

Feather is an insurance provider building a fully digital experience with modern, flexible plans for expats living abroad.