Claims Operations Manager (m/f/x) at Progyny Global

Berlin, , Germany -

Full Time

Start Date

Immediate

Expiry Date

30 Mar, 26

Salary

58000.0

Posted On

30 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Operations, Benefit Interpretation, Documentation, Process Improvement, Regulatory Compliance, Analytical Thinking, Communication Skills, Collaboration, Attention to Detail, Operational Performance, Stakeholder Management, Systems-Oriented Mindset, Problem Solving, Team Leadership, Project Management, Healthcare Knowledge

Industry

Hospitals and Health Care

Description

Who We Are At Progyny Global, we’re on a mission to make fertility, pregnancy, and family-forming care accessible worldwide. As part of Progyny Inc., we combine world-class clinical expertise with groundbreaking technology to deliver inclusive, culturally competent support for families everywhere. Your Mission As Claims Operations Manager, you play a key role in supporting and evolving our global claims operations. You will work hands-on across claims processes, partner coordination, and benefit interpretation, helping ensure claims are processed accurately, efficiently, and in line with benefit design and regulatory requirements. This role is ideal for someone with insurance-adjacent experience who enjoys working in complex systems and collaborating across teams to improve processes. You will work closely with Member Experience, Legal, Product, and Tech, supporting complex cases and contributing to continuous improvement of our claims ecosystem. Tasks 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 Why Join Us 💰 Competitive Base Salary: From €53000 – €58000 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. We believe that great leaders come from diverse backgrounds. If you’re passionate about building high-performing teams, delivering world-class care, and shaping the future of global member experience, we’d love to hear from you.

Responsibilities

The Claims Operations Manager will review, assess, and process claims while ensuring compliance with benefit design and regulatory requirements. This role also involves collaborating with various teams to improve claims workflows and partner collaboration.