Claims Operations Manager in hybrid role at Progyny, supporting global claims operations and collaborating with various teams. Ideal for candidates with insurance-adjacent experience and a structured mindset.
Responsibilities
Claims Operations
Review, assess, and process claims end-to-end, applying benefit rules, documentation requirements, and validation logic.
Monitor quality metrics and operational performance.
Coordinate escalations and complex case resolution in close collaboration with internal stakeholders (e.g. Member Experience, Leadership Team, Legal).
Identify recurring issues and drive continuous improvement across claims workflows and partner collaboration.
Benefit Interpretation & Documentation
Apply benefit and policy logic to real-world claims scenarios.
Partner with Member Experience and subject matter experts to ensure benefit interpretation is consistent, accurate, and member-friendly.
Support the maintenance of clear documentation for claims logic and operational guidelines.
Claims Processes & Product Support
Contribute to the ongoing development of claims processes and the Wallet product.
Translate benefit rules into clear, scalable operational workflows.
Support process updates as new markets, benefit types, or regulatory requirements are introduced.
Requirements
Strong understanding of regulatory, compliance, and legal considerations, ideally in a global or multi-market context.
Bachelor’s degree in a relevant field (e.g. business, healthcare, insurance, law, or operations), or equivalent practical experience, plus 5+ years of professional experience in claims operations, insurance, benefits administration, or a related operational role.
Experience collaborating with senior stakeholders across Legal, Product, Tech, and global operations teams.
Highly structured, systems-oriented mindset with a strong sense of ownership and accountability.
Strong attention to detail, analytical thinking, and clear, professional communication skills.
Benefits
💰 Competitive Base Salary: From €53,000 – €58,000 per year.
🎯 Bonus Program & Company Equity: Bonuses and ownership opportunities to share in Progyny’s success.
👶 Fertility & Family-Building Benefits: Access to the Progyny Global Platform with a €5,000 annual benefits budget.
🧘 Mental Health Support: 1:1 psychologist sessions and wellness tools via Nilo Health.
🚲 Sustainable Mobility Benefit: Choice between a Dance e-bike subscription or a BVG public transport ticket.
💪 Urban Sports Club Discount: Access to discounted fitness and wellness activities.
🌴 Paid Leave: 30 days of paid leave per year.
🏡 Hybrid Work: Work from home up to two days per week.
✈️ Remote Work: Up to 8 weeks of remote work per year.
🍽️ Weekly Team Lunches: Team lunch every Thursday.
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