Apryl

Individual and Family Services

Progyny Global

11-50

Germany

We’re Apryl, part of the Progyny Inc family.

Our shared mission? To make fertility and family-forming care accessible everywhere, breaking down barriers so that anyone can start a family, no matter where they are. With Progyny's support, we're set to amplify our impact globally, reaching more individuals and families than ever before.

Our goal is to simplify the claims process for our members, transforming it from a challenging task to a seamless experience. We are looking for a detail-oriented and diligent Claims Expert to join our team.

## Tasks

In this role, you will be responsible for reviewing incoming member out-of-pocket expenses. You will collaborate with the Member Care and Finance team to ensure an exceptional member experience.

*   **Claims Processing:** Manage incoming claims in our claims management system, ensuring all information is accurate and up-to-date.
*   **Member and Provider Communication:** Communicate with members and providers regarding missing or unclear information and provide timely updates on claim status. Liaise with internal teams to resolve escalated claim issues and manage inquiries received via the Claims inbox.
*   **Claims Validation:** Review and validate claims for accuracy and completeness, process awards in accordance with company policies, and resolve claim reprocessing and authorization issues.
*   **Quality Assurance & Compliance:** Conduct regular quality checks, audits, and review reports to ensure claims comply with internal policies and external regulations. Maintain thorough knowledge of processing requirements for each plan.
*   **Case Management:** Ensure timely resolution of open claims and inquiries. Schedule weekly/biweekly calls to address claim status, denial reasons, and reprocessing issues.
*   **Process Optimization:** Identify opportunities to enhance productivity and streamline claims processing workflows, recommending and implementing improvements as needed.

## Requirements

*   Experienced in processing claims and maintaining high accuracy
*   Highly detail-oriented and organized
*   Structured thinker
*   Excellent verbal and written communication skills
*   Problem-solving skills to analyze, troubleshoot and resolve issues
*   Proficiency with Microsoft Excel / claims management systems
*   This position requires on-site presence in our Berlin office
*   You are eligible to work within the EU

**It would be nice if you have**

*   Previous experience in customer service (Healthcare / Insurance)
*   Bachelor’s degree in business, insurance, healthcare or equivalent

## Benefits

*   Annual gross salary range for Berlin-based applicants: **€50,000-55,000**
*   Bonus program and company equity
*   Fertility & family building benefit: Get access to our _Apryl_ Platform and a 5.000€ benefit budget
*   Mental health benefit: Access to 1:1 sessions with experienced psychologists & in-app training & tools from _Nilo Health_
*   Sustainable mobility benefit: _Dance_ e-bike subscription or monthly public transportation ticket (BVG)
*   Hybrid work: Up to 2 days a week work from home
*   Remote work: Up to 8 weeks per year

We believe in equal opportunities. We celebrate diversity and are committed to creating an inclusive environment for all employees.

If you're passionate about helping others and want to make a difference in people's fertility and family-forming journeys, we encourage you to apply and join our mission at Apryl.

Employee

Professional / Experienced

We’re Apryl, part of the Progyny Inc family.
Our shared mission? To make fertility and family-forming care accessible everywhere, breaking down barriers so that anyone can start a family, no matter where they are. With Progyny&#39;s support, we&#39;re set to amplify our impact globally, reaching more individuals and families than ever before.
Our goal is to simplify the claims process for our members, transforming it from a challenging task to a seamless experience. We are looking for a detail-oriented and diligent Claims Expert to join our team.
<h2 id="tasks">Tasks</h2>
In this role, you will be responsible for reviewing incoming member out-of-pocket expenses. You will collaborate with the Member Care and Finance team to ensure an exceptional member experience.
<ul>
<li>Claims Processing: Manage incoming claims in our claims management system, ensuring all information is accurate and up-to-date.</li>
<li>Member and Provider Communication: Communicate with members and providers regarding missing or unclear information and provide timely updates on claim status. Liaise with internal teams to resolve escalated claim issues and manage inquiries received via the Claims inbox.</li>
<li>Claims Validation: Review and validate claims for accuracy and completeness, process awards in accordance with company policies, and resolve claim reprocessing and authorization issues.</li>
<li>Quality Assurance &amp; Compliance: Conduct regular quality checks, audits, and review reports to ensure claims comply with internal policies and external regulations. Maintain thorough knowledge of processing requirements for each plan.</li>
<li>Case Management: Ensure timely resolution of open claims and inquiries. Schedule weekly/biweekly calls to address claim status, denial reasons, and reprocessing issues.</li>
<li>Process Optimization: Identify opportunities to enhance productivity and streamline claims processing workflows, recommending and implementing improvements as needed.</li>
</ul>
<h2 id="requirements">Requirements</h2>
<ul>
<li>Experienced in processing claims and maintaining high accuracy</li>
<li>Highly detail-oriented and organized</li>
<li>Structured thinker</li>
<li>Excellent verbal and written communication skills</li>
<li>Problem-solving skills to analyze, troubleshoot and resolve issues</li>
<li>Proficiency with Microsoft Excel / claims management systems</li>
<li>This position requires on-site presence in our Berlin office</li>
<li>You are eligible to work within the EU</li>
</ul>
It would be nice if you have
<ul>
<li>Previous experience in customer service (Healthcare / Insurance)</li>
<li>Bachelor’s degree in business, insurance, healthcare or equivalent</li>
</ul>
<h2 id="benefits">Benefits</h2>
<ul>
<li>Annual gross salary range for Berlin-based applicants: €50,000-55,000</li>
<li>Bonus program and company equity</li>
<li>Fertility &amp; family building benefit: Get access to our Apryl Platform and a 5.000€ benefit budget</li>
<li>Mental health benefit: Access to 1:1 sessions with experienced psychologists &amp; in-app training &amp; tools from Nilo Health</li>
<li>Sustainable mobility benefit: Dance e-bike subscription or monthly public transportation ticket (BVG)</li>
<li>Hybrid work: Up to 2 days a week work from home</li>
<li>Remote work: Up to 8 weeks per year</li>
</ul>
We believe in equal opportunities. We celebrate diversity and are committed to creating an inclusive environment for all employees.
If you&#39;re passionate about helping others and want to make a difference in people&#39;s fertility and family-forming journeys, we encourage you to apply and join our mission at Apryl.

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