Claims and Appeals Processor (Contract)
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Job Description
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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!
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 team-wide 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:
- A 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.
- A 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.
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Sana Benefits
View Company ProfileSana Benefits is a premier, enterprise-grade health-insurance and benefit-management platform engineered to orchestrate massive-scale SMB healthcare ecosystems and intelligent frictionless insurance-funding workflows. Operating as a highly integrated, vertically-integrated "level-funded" insurance hub, the company eliminates the operational friction of traditional, bloated fully-insured models—which often burden small and midsize businesses (SMBs) with unpredictable costs and hidden fees—by seamlessly deploying advanced primary-care telemetry (Sana Care), rigorous cost-transparency architectures, and cohesive omnichannel care-navigation frameworks. Moving beyond rigid legacy carrier paradigms, Sana empowers growing teams to dynamically synchronize their benefits-administration, employee-enrollment, and claims-management pipelines with elite autonomous execution. Under the hood, their sophisticated proprietary data infrastructure natively manages complex provider-network ingestion (1.2M+ providers), instantaneous $0-cost virtual-primary-care routing, and automated level-funded financial-management cycles, enabling businesses to budget with confidence while driving down systemic healthcare spending. What sets Sana apart is its uncompromising dedication to frictionless healthcare orchestration; by bridging the gap between highly complex, volatility-prone insurance landscapes and accessible, human-centric wellness experiences, the platform empowers SMB employers to radically accelerate their benefits-offering velocity, eliminate administrative and billing-process bottlenecks, and build an unassailable foundation for continuous employee retention and operational dominance in the modern, hybrid-workforce healthcare landscape.
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