Health claims lead (f/m/x)

About This Opportunity

We are representing a confidential insurance technology organization in their search for a Health Claims Lead to own claims decisions across their expat and international health insurance books. This is a genuine leadership role where you'll make coverage, decline, and settlement decisions from day one—not recommendations that wait for approval—while building the systems and playbook that let the function scale.

You'll manage insurance carrier relationships, decide how and when to work with third-party administrators, and close operational gaps with product and engineering teams. This role suits someone who has handled cross-border health claims, understands medical coding and provider billing, and thrives in building processes while running them.

Location: EU Remote or Berlin-based

Responsibilities

• Make final claims decisions on coverage, declines, settlement amounts, and goodwill within policy terms, with real authority
• Handle expat and international health claims including cross-border invoices across multiple languages, billing conventions, currencies, and coordination with statutory and private coverage
• Own claims reporting and bordereaux to insurance carriers, manage contentious cases and coverage disputes, and maintain audit-ready records
• Decide where third-party administrators add value and manage their instructions, quality, turnaround times, and commercial performance
• Collaborate with product and engineering teams to close gaps across intake, documents, decision support, payout processes, and automation
• Run audits and fraud checks, working toward semi-automated monitoring with data teams
• Write the operational playbook so the function doesn't depend on one person, and train future team members

What We're Looking For

Must have:

• Hands-on experience handling health claims across borders or in international contexts
• Familiarity with medical coding and provider billing practices
• Instinct for automation and AI tooling, with daily practical use
• Comfort making tough decisions daily, including declining claims, while maintaining professional composure
• Pragmatic approach to working in unfinished systems—improving them while keeping them running
• Fluent English

Nice to have:

• German, Spanish, or French language skills
• Experience with moratorium underwriting
• Medical background or clinical training
• Experience in an MGA or delegated authority environment
• Experience managing third-party administrators

How We Work With You

Our talent team at Get A Job.ai partners with this organization to find exceptional candidates. When you apply through our platform, a recruiter will screen your background and walk you through the opportunity in detail. If there's a mutual fit, we'll submit your profile to our client and support you throughout their interview process.

The client's process includes: initial phone call with their People team (30 minutes), hiring manager discussion (1 hour), take-home case study (3-4 hours of work), case study discussion (90 minutes), conversation with Head of Operations about remote-first working style (45 minutes), and final interview with a leadership team member (45 minutes).

Please do not contact the employer directly. All applications and communication should go through Get A Job.ai.

Pay

Compensation details will be discussed during the screening process based on your experience and location within the EU.

Get A Job.ai is an equal opportunity recruiter. We work with clients who value diverse teams and encourage candidates from all backgrounds and educational paths to apply.