Health Plan Operations Associate

Summary

Join Modern Health as a Health Plan Operations Associate and contribute to a supportive, fast-paced environment focused on improving mental health benefits. You will play a key role in maintaining foundational systems and processes supporting health plan integration, including member eligibility checks, claim submissions, and payment processing. This role requires strong attention to detail, problem-solving skills, and excellent communication. The position offers a comprehensive benefits package, including health insurance, paid time off, and professional development opportunities. Modern Health is a fully remote company with a collaborative culture, and this role is open to candidates in several states. The ideal candidate will have 1-2 years of relevant experience and a passion for improving the mental health landscape.

Requirements

• You have 1-2 years of relevant work experience (claims experience is a plus)
• You are highly detail-oriented and organized
• You are a structured thinker and love checking things off your to-do list
• You have excellent verbal and written communication skills
• You are a problem solver and are able to analyze, troubleshoot and resolve issues
• You enjoy working with different kinds of people and are great at building relationships
• You are a team player who enjoys identifying group pain points and improving them
• You are humble, scrappy, and thrive in fast-paced environments

Responsibilities

• Track claims and denials through the entire claim lifecycle
• Manage and establish new systems to support claims processing and related areas
• Identify gaps in claims and reach out to providers for missing information
• Help members troubleshoot issues involving claims or eligibility
• Create documentation and training materials for the broader Ops team
• Provide reporting and other visibility into this function
• Complete other special projects as needed

Benefits

• Medical / Dental / Vision / Disability / Life Insurance
• High Deductible Health Plan with Health Savings Account (HSA) option
• Flexible Spending Account (FSA)
• Access to coaches and therapists through Modern Health's platform
• Generous Time Off
• Company-wide Collective Pause Days
• Parental Leave Policy
• Family Forming Benefit through Carrot
• Family Assistance Benefit through UrbanSitter
• Professional Development Stipend
• 401k
• Financial Planning Benefit through Origin
• Annual Wellness Stipend to use on items that promote your overall well being
• New Hire Stipend to help cover work-from-home setup costs
• ModSquad Community: Virtual events like active ERGs, holiday themed activities, team-building events and more
• Monthly Cell Phone Reimbursement