Senior Claims Examiner: AI-Driven Health Benefits

Nara Health; Chicago (IL); Presencial; USD 75.000 - 110.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance with company subsidy

Unlimited PTO policy

Home office equipment budget

Team retreats and offsites

Descripción de la vacante

Nara Health, a Chicago-based AI-native benefits administrator, seeks a seasoned claims processor to adjudicate health, dental, and vision claims with accuracy and judgment. You’ll influence AI-enabled workflows by feeding patterns and documentation from real cases, while maintaining high quality and compliance in every review.

Join a mission-driven team focused on improving healthcare affordability and accessibility, with a strong emphasis on ownership, learning velocity, and clear written

Formación

• 5+ years of experience in TPA health insurance claims processing.
• Proficiency with spreadsheet software (Excel, Google Sheets).
• Experience using multiple software systems for claims processing.
• Proven ability to identify patterns and edge cases in claims processing.
• Strong logical thinking and structured problem-solving approach.
• Experience creating detailed process documentation.
• Excellent written and verbal communication abilities.
• Demonstrated ability to work independently and manage time effectively.

Responsabilidades

• Process and adjudicate health, dental, and vision insurance claims.
• Perform QA reviews of auto-adjudicated claims to ensure accuracy and identify improvements.
• Analyze claim documentation for accuracy, completeness, and plan benefits compliance.
• Collaborate with the technology team to identify patterns and automation opportunities.
• Share claims processing expertise and contribute to knowledge base development.
• Participate in continuous improvement of claims processing workflows.
• Document best practices and unusual case resolutions.

Conocimientos

Claims processing

Excel

Google Sheets

Pattern detection

Documentation

Written and verbal communication

Time management

Herramientas

Claims processing software

Descripción del empleo

Nara Health, a Chicago-based AI-native benefits administrator, seeks a seasoned claims processor to adjudicate health, dental, and vision claims with accuracy and judgment. You’ll influence AI-enabled workflows by feeding patterns and documentation from real cases, while maintaining high quality and compliance in every review.

Join a mission-driven team focused on improving healthcare affordability and accessibility, with a strong emphasis on ownership, learning velocity, and clear written