The Claims Processor will handle the processing and adjudication of medical claims, ensuring timely and accurate payments while resolving issues and communicating with claimants. Responsibilities include managing appeals, maintaining accurate claim records, and collaborating to improve claims processes.
Sana’s vision is simple yet bold: make healthcare easy.
We all know navigating healthcare in the U.S. is confusing, costly, and frustrating -- and our members are used to feeling that pain. That’s why we’re building something different: affordable health plans designed around Sana Care, our integrated care model connecting members with unlimited primary care and expert care navigation at no additional cost to them.
Whether it’s a quick prescription refill or guidance through a complex medical journey, Sana Care makes it feel effortless to get the right care at the right time. And for employers and brokers, we’ve built intuitive tools to make managing health benefits just as seamless.
If you love solving hard problems that make people’s lives easier, come build with us.
We’re currently seeking a Claims Processor who will be responsible for processing insurance claims in a timely and accurate manner. This includes gathering and verifying claim information, researching and resolving claim issues, and communicating with claimants to ensure their satisfaction.
We are building a distributed team and encourage all applicants to apply, regardless of location.
What you will do:
- Ensure the timely and accurate adjudication and payment of medical claims, following health plan policies and procedures, consulting with team members, care partners and advisors as necessary. Maintain accurate and up-to-date notes of all claims processed.
- Process appeals and disputes by gathering and verifying claim information, researching and resolving claim issues, and communicating outcomes to appropriate parties.
- Become an in-house expert on all claims-related matters and provide answers and support to Customer Success and Customer Support teams.
- Identify operational issues and escalate them to the appropriate internal team.
- Contribute to teamwide goals to improve claims processes and integrate additional functions into our daily operations.
- Work independently and as part of a team to meet deadlines and daily processing quotas. Your success will be measured on your ability to complete daily and weekly targets.
What you will do:
- Two-year degree and/or two years of claims adjudication and processing experience
- Unparalleled attention to detail. You love getting into the weeds to get things done.
- Excellent written and verbal communication skills.
- Ability to work independently and as part of a team.
- Fast learner. Entrepreneurial. Self-directed.
- Ability to meet deadlines and work under pressure.
- Experience in claims processing, knowledge of insurance principles and procedures is a plus.
Benefits:
- Remote company with a fully distributed team – no return-to-office mandates
- Flexible vacation policy (and a culture of using it)
- Medical, dental, and vision insurance with 100% company-paid employee coverage
- 401(k), FSA, and HSA plans
- Paid parental leave
- Short and long-term disability, as well as life insurance
- Competitive stock options are offered to all employees
- Transparent compensation & formal career development programs
- Paid one-month sabbatical after 5 years
- Stipends for setting up your home office and an ongoing learning budget
- Direct positive impact on members’ lives – wait until you see the positive feedback members share every day
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