Claims Processor
医疗保健的愿景是让医疗服务变得简单。我们都同意，美国医疗保健只是太难了。我们的成员每天都会感觉到这种痛苦。我们希望创造一个体验，当你需要访问我们的医疗系统时就能轻松地感觉到。如果你需要什么东西，你知道要去哪里才能得到它，那就是一点击 （或尽可能少的点击！）从那里获得。易于实现的视野最美丽的是它传递一种独特的感觉。我们本能的人类知道什么时候容易与困难，即使我们无法解释为什么。我们作为公司努力在他们的医疗保健旅程每个阶段向所有成员提供一个简单的途径。如果你对通过无的护理体验和可负担的福利为小企业提供更好的医疗保健感到激动，请加入我们！我们目前正在寻找一个应聘申请处理员，负责及时准确地处理保险索赔。这包括收集和验证索赔信息，研究和解决索赔问题，并与索赔者沟通以确保他们的满意度。我们正在建立一个分布式团队，鼓励所有申请人无论在哪个地方都申请。你将做什么：· 确保及时和准确地裁定和支付医疗索赔，遵循健康计划的政策和程序，酌情咨询团队成员，护理合作伙伴和顾问。保持处理的所有索赔的准确和最新记录。·通过收集和验证索赔信息，研究和解决索赔问题并向适当各方传达结果来处理上诉和争端。·成为所有与索赔相关问题的内部专家，为客户成功和客户支持团队提供答案和支持。·确定运营问题并将其升级到合适的内部团队。· 贡献团队的目标，以改善索赔流程和将额外功能集成到我们的日常运营中。·独立工作，作为一个团队的一部分来满足截止日期和每天处理配额。你的成功将取决于你完成每天和周次目标的能力。关于你：·两年学位和/或两年的索赔裁定和处理经验 · 无与伦比的细节关注。你喜欢进入杂草做事情。·优秀的书面和口头沟通技能。· 能够独立工作和作为一个团伙的一部分。
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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 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.
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
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.
Originally posted on Himalayas