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Contract Claims Processor (Month to Month)

Role overview

Qualifications

  • Two-year degree and/or two years of claims adjudication and processing experience
  • Unparalleled attention to detail
  • Excellent written and verbal communication skills
  • Ability to meet deadlines and work under pressure

Responsibilities

  • Ensure the timely and accurate adjudication and payment of medical claims
  • Process appeals and disputes by gathering and verifying claim information
  • Become an in-house expert on all claims-related matters
  • Identify operational issues and escalate them to the appropriate internal team

Key facts

  • Remote from: United States
  • Full time
  • Mid-level (2-5 years)
  • $43K – $59K / year
  • English

Hard skills

Other skills

  • Detail Oriented
  • Communication
  • Research
  • Quick Learning
  • Entrepreneurship
  • Time Management
  • Problem Solving

About the company

Sana logo

Sana

  • Health Insurance & Payers
  • Scaleup
  • 51–200
Sana is on a mission to make healthcare understandable, accessible, and affordable for all. The first step: better health plans for small businesses. We help small businesses offer high-quality benefits, save on healthcare costs, and avoid expensive employee turnover. Our members get comprehensive medical, dental, and vision coverage, plus access to over a dozen $0 healthcare options — such as virtual pediatrics, mental health, and maternity care. By bringing healthcare innovation downmarket to the generally neglected small business sector, Sana is laying the groundwork for a healthcare revolution. Sana is hiring in Operations, Product, Engineering, Sales and more - APPLY TODAY! http://bit.ly/joinsana

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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 Contract 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.

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.


Salary: 43000 - 59000 USD per year

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