Hybrid Claims Operations Manager

Posted 2 weeks ago

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About the role

  • 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.

Job title

Claims Operations Manager

Job type

Experience level

Mid levelSenior

Salary

€53,000 - €58,000 per year

Degree requirement

Bachelor's Degree

Location requirements

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