Claims Processor

This is a fully remote position, open to applicants in United States.

📋 Description

• Ensure the prompt and precise adjudication and payment of medical claims, adhering to health plan policies and procedures.

• Collaborate with team members, care partners, and advisors as required.

• Keep accurate and current records of all processed claims.

• Handle appeals and disputes by collecting and verifying claim information, researching and resolving claim issues, and communicating results to relevant parties.

• Become an in-house authority on claims-related topics and provide assistance and support to Customer Success and Customer Support teams.

• Identify operational challenges and escalate them to the suitable internal team.

• Contribute to team-wide objectives aimed at enhancing claims processes and incorporating additional functions into daily operations.

• Operate both independently and collaboratively to meet deadlines and daily processing quotas; accomplish daily and weekly targets.

⛳️ Requirements

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

• Exceptional attention to detail.

• Strong written and verbal communication abilities.

• Capability to work both independently and as part of a team.

• Quick learner; entrepreneurial mindset; self-motivated.

• Ability to meet deadlines and perform well under pressure.

• Experience in claims processing; familiarity with insurance principles and procedures is an advantage.

🏝️ Benefits

• Remote company with a fully distributed team – no mandatory return-to-office policies.

• Flexible vacation policy (and a culture that encourages taking it).

• Medical, dental, and vision insurance with 100% company-paid employee coverage.

• 401(k) plan with company match, along with FSA and HSA options.

• Paid parental leave.

• Short-term and long-term disability insurance, as well as life insurance.

• Competitive stock options available to all employees.

• Transparent compensation structure and established career development programs.

• One-month paid sabbatical after five years of service.

• Stipends for home office setup and a continuous learning budget.

• Directly contribute to improving members’ lives – wait until you hear the positive feedback members share every day.