Member Claims Associate

Job Title: Member Claims Associate

Location: Plano, TX (Hybrid 3 Days Onsite)

Duration: 6 Months

Pay Rate: $24.20/hr on W2

Contract Start date: July 6, 2026

Contract End date: December 31, 2026

You must be available for 5 weeks of required training beginning on the start date from July 6 - Aug 7. You will not be able to take time off during the training period.

Job Description:

As a Member Claims Associate Contractor, you will drive the core processes behind employer-sponsored medical plans and help our members navigate their most complex claims issues. In this role, you will gain a comprehensive, hands-on understanding of health plan operations—from processing medical claims and deciphering complex coding to managing regulatory requirements and network partner relationships. Everything you do will be through the lens of delivering an exceptional member experience.

This contract is a gateway to becoming an expert in the payer-side of healthcare. Backed by our established, knowledgeable teams, you will play an essential role in scaling our operations and collaborating on a growing team at the forefront of redefining the healthcare industry.

What you'll do:

• Execute the daily operations of a health plan, including processing medical claims, researching and responding to the members' most complicated questions, tracking your accuracy around core metrics, and troubleshooting the many operational challenges that affects the business
• Be part of the team that is continuously adapting to improve efficiency and scalability
• Think critically and strategically to continually boost teamwork and communication across offices
• Gain additional skills across different areas of the business over time
• Develop in-depth industry expertise in the healthcare economy
• Cultivate a culture that aligns with values and incorporates the unique aspects of the team
• Reporting to the Manager of Member Claims, this is an essential role on the Customer Experience team

To be successful in this role, you'll need:

• Above all, you are driven, curious, and take ownership for everything you do
• You can become proficient with a large volume of information quickly
• You are a committed team player
• You are excited to build and adapt to the adventures of working on a growing team
• You are passionate about being a part of a fast-growing company
• You have a passion for mission to transform the health insurance experience for employers and their employees

Nice to have:

Bachelor's degree or 1 or more years of work experience

PrideGlobal and its affiliates offer eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.

Equal Employment Opportunity

PrideGlobal and it's affiliates are an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment

PrideGlobal and it's affiliates are a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations

We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates : Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.