Operations Automation Specialist

Dallas, TX - Hybrid (3x in office/week); New York, NY - Hybrid (3x in office/week). Posted a month ago

The role

You will resolve provider inquiries and build AI-assisted workflows to automate these processes. You will audit claims, query data using SQL, and design tools to reduce manual work.

What you will do

Work a live queue of provider claims inquiries through to accurate resolution
Audit individual claims across systems to confirm correct submission, validation, pricing, and payment
Escalate genuine pricing or appeals determinations
Query claims, pricing, and provider data directly using SQL
Design and build AI-assisted workflows to triage inquiries and validate payments
Test and iterate workflows against real ticket volume
Work on root causes of upstream issues like deferred claims or ingestion errors
Contribute to provider self-service

Required qualifications

Communicate clearly and confidently with providers and internal stakeholders
Have a working understanding of the business and financial side of how claims and payments move
Have a desire to expand SQL skills and use Python and AI tools
Be comfortable in ambiguity
Start by performing the manual resolution work

Nice to have

Hands-on SQL and/or Python experience
Real fluency with modern AI tools including agentic coding tools like Claude Code
A year or more of work experience in roles requiring real conversations with people
Background or coursework in process improvement
A business, finance, economics, or business-intelligence academic background
Exposure to revenue cycle, claims, payer operations, or provider billing
Experience in a support, service, or operations function

Benefits

Medical Insurance
Dental Insurance
Vision Insurance
Short & Long Term Disability
Life Insurance
401k with company match
Paid Time Off
Paid Parental Leave

About the company

Lantern is a specialty care platform that connects people with a Network of Excellence of specialists for surgery, cancer care, infusions, and more. It is trusted by large employers to deliver care to more than 6 million members.