Remote Claims & Appeals Specialist

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 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.