Care Navigator

At SafetyWing (YC W18), we’re building a global social safety net for remote workers—simple health, insurance, and retirement products designed to replace national welfare systems. Our mission is to remove geographical borders as a barrier to equal opportunity and freedom for everyone. If we succeed, we believe this will be one of the most important tasks of our time. 🌎 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: helping members understand their benefits, find high-value in-network care, and get through the appeals process when they need it.You'll 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 - a confusing bill, a denied claim, a question about what's covered. You'll also help improve our product based on the patterns you notice in claims and cost data across the cases you handle.💻 Your responsibilities will include: • Being the warm, persistent point of contact a member can hand a confusing bill, denial, or complex question to • Helping members navigate the appeals process when they don't know where to start, and reviewing complex cases as they come up • Reviewing EOBs to catch any errors and advocating for the member • Coordinating between a member and their providers to resolve billing and coverage issues end to end • Helping members and providers understand what requires prior authorization and making sure it's submitted correctly and on time, including specialty and pharmacy pre-authorization • Translating plan design and benefits into plain language so members understand what is and isn't covered • Pointing members toward high-value, in-network care and providers - this is administrative navigation, not clinical advice • Flagging patterns you notice in claims and costs to help us keep improving the plan 🧪 You are a good fit if you: • Have several years in a medical-administrative or patient-facing coordination role • Have hands-on experience with claims, medical billing, and pre-authorizations, and can read an EOB and spot when something's off • Have working familiarity with CPT and ICD coding and how charges are built and submitted • Are 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 beyond base pay: • 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! 🚀 We look forward to hearing from you! Originally posted on Himalayas