Claims Operations Manager (mfx)

Who We Are

At Progyny Global were 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
• Bachelors 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: Fromper year.
• Bonus Program & Company Equity: Bonuses and ownership opportunities to share in Progynys success.
• Fertility & Family-Building Benefits: Access to the Progyny Global Platform with a 5000 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 youre passionate about building high-performing teams delivering world-class care and shaping the future of global member experience wed love to hear from you.