Claims Processor

Sana Benefits; Northern (KY); Hybrid; USD 43,000 - 59,000; Full time

Benefits offered by this job

Remote-friendly company

Medical, dental, vision insurance

401(k) with company match

Paid parental leave

Stock options

Learning budget

Home office stipend

Sabbatical after 5 years

Job summary

Sana Benefits is seeking a Claims and Appeals Processor for a remote, distributed team in the United States. The role focuses on timely adjudication, accurate claim processing, and resolution of appeals.

You’ll support Customer Success teams and help optimize claims workflows while meeting daily and weekly quotas. We value detail-oriented, self-directed individuals who can work independently or with a team, and who bring strong communication skills.

Qualifications

• Two-year degree and/or two years of claims adjudication and processing experience.
• 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.

Responsibilities

• 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.
• 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 elevate 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.

Skills

Attention to detail

Communication skills

Independent & team work

Fast learner

Deadline-driven

Claims processing experience

Education

Two-year degree

Experience in claims adjudication

Job description

Sana's vision is to make healthcare easy.

All of us can agree healthcare is simply too hard in the US. And our members feel that pain day in and day out. We aim to create an experience that simply feels easy when you need to access our healthcare system. If you need something, you know where to go to get it with care that is a click (or as few clicks as possible!) away.

What's beautiful about a vision oriented toward "easy" is how it imparts a singular feeling. We instinctively know as humans when something is easy versus hard, even if we can't explain why. We fight as a company to make an easy pathway available to all our members at every stage of their healthcare journey. If you feel passionate about delivering better healthcare to small businesses through a seamless care experience and affordable benefits, join us!

We're currently seeking a Claims and Appeals 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 elevate 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.

About you:

• 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) with company match, 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

$43,000 - $59,000 a year

Our cash compensation amount for this role is targeted at $43,000-59,000 (this is an hourly role at $20.67-$28.36/hour) base + equity per year for all US-based remote locations. Final offer amounts are determined by multiple factors including candidate experience and expertise and may vary from the amounts listed above are determined by multiple factors including candidate experience and expertise and may vary from the amounts listed above.

About Sana

Founded in 2017, Sana is a health plan solution built for small and midsize businesses - designed around our integrated primary care service, Sana Care. It's the foundation of everything we build: ensuring members can easily access high-quality, affordable care while employers and brokers have the tools they need to manage company benefits with confidence.

We've been remote-first since day one, with a fully distributed team across the U.S. We value curiosity, ownership, and speed - and we build in the open, together. If you're energized by solving complex, meaningful problems and want to help reshape how healthcare works from the inside out, we'd love to meet you.