Claims Processor I

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

📋 Description

• Identify and input essential procedure codes, diagnosis codes, and claims details as necessary.

• Verify claim data for accuracy and follow up on any missing or ambiguous information.

• Assess claim documentation to ensure compliance with Sidecar Health policies and processing guidelines.

• Report discrepancies or unusual details to senior processors or supervisors for additional evaluation.

• Comply with productivity, quality, efficiency, and attendance standards.

• Keep precise work records, notes, and documentation within claims systems.

• Follow predefined workflows and escalate issues as required.

• Engage in training sessions to enhance knowledge, system proficiency, and claims processing capabilities.

• Collaborate with colleagues during huddles, sharing inquiries, obstacles, and process insights.

• Provide input on claim processing guidelines and assist in discovering opportunities to streamline or enhance workflows.

• Maintain confidentiality and compliance standards, including those set by HIPAA.

• Assist with special projects, seasonal workflows, or cross-departmental initiatives as directed.

• Review internal audit findings and implement corrective actions to enhance accuracy and prevent future mistakes.

⛳️ Requirements

• Over 3 years of experience in claims processing, medical billing, healthcare administration, or a similar operational role (or equivalent experience in a regulated, process-oriented production setting).

• Experience in high-output environments where production, idle time, and quality metrics are tracked, and performance is visible.

• Strong sense of ownership and accountability - takes charge of outcomes, sees claims through to resolution, and avoids passing on work to prevent errors or complications.

• Member-first approach, understanding that claim accuracy, turnaround time, and responsible management directly impact members’ access to care and financial security.

• Ability to handle multiple claims concurrently while adhering to established service-level agreements (SLAs).

• Strong analytical abilities to detect discrepancies, investigate root causes, and apply policies accurately rather than processing transactions mechanically.

• Proficiency in navigating various systems and tools simultaneously, with a quick learning ability for new platforms.

• High degree of professionalism and discretion when managing sensitive health and financial information in accordance with regulations (e.g., HIPAA).

• Capacity to work independently in a remote setting, demonstrating accountability, consistent output, and responsiveness during scheduled hours.

• Exceptional attention to detail and a commitment to precision when reviewing and entering claim data.

• Familiarity with claims processing platforms or healthcare operational systems.

• Ability to work efficiently in a remote environment.

🏝️ Benefits

• Competitive hourly pay and equity opportunities.

• Medical, Dental, and Vision benefits with no waiting period.

• Paid vacation and company holidays.

• Company-provided IT equipment (laptop, monitors).

• Continuous opportunities for professional development and career growth.