Claims Processor I

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $23 - $25 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Sidecar Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2018

⚕️ Healthcare Insurance

Healthcare Insurance

Sidecar Health is a health insurance company that provides comprehensive major medical insurance with upfront pricing and no network restrictions or referral requirements. Their goal is to put employees in control of their healthcare by giving them a clear budget for care and allowing them to choose any doctor without surprise costs. They emphasize access to prescriptions without limitations and protection for unplanned care. Sidecar Health also offers transparent pricing and the option for members to save money if they find providers who charge less than their plan pays. Their offerings include individualized access plans and employer plans, ensuring members always have a choice of qualified doctors.

📋 Description

• Identify and enter basic procedure codes, diagnosis codes, and claims information as required • Validate claim data for completeness and follow up on missing or unclear information • Review claim documentation to ensure it aligns with Sidecar Health policies and processing rules • Flag discrepancies or unusual information to senior processors or supervisors for further review • Adhere to productivity, quality, efficiency, and attendance expectations • Maintain accurate work records, notes, and documentation within claims systems • Follow established workflows and escalate issues when needed • Participate in training sessions to build knowledge, system proficiency, and claims processing skills • Collaborate with peers in huddles, sharing questions, blockers, and process insights • Provide feedback on claim processing instructions and help identify opportunities to simplify or improve workflows • Uphold confidentiality and compliance requirements, including HIPAA • Support special projects, seasonal workflows, or cross-functional initiatives as assigned • Review internal audit results and take corrective steps to improve accuracy and prevent future errors

🎯 Requirements

• 3+ years of experience in claims processing, medical billing, healthcare administration, or a related operational role (or equivalent experience in a regulated, process-driven production environment) • Experience working in high-production environments where output, idle time, and quality metrics are monitored, and performance is transparent • Strong sense of ownership and accountability - takes responsibility for outcomes, follows claims through resolution, and does not rely on transferring work to avoid errors or complexity • Member-first mindset, recognizing that claim accuracy, turnaround time, and responsible ownership directly affect members’ access to care and financial wellbeing • Ability to manage multiple claims simultaneously while meeting defined service-level agreements (SLAs) • Strong analytical skills with the ability to identify discrepancies, investigate root causes, and apply policy accurately rather than processing transactions mechanically • Proficiency navigating multiple systems and tools simultaneously, with the ability to learn new platforms quickly • High level of professionalism and discretion when handling sensitive health and financial information in compliance with regulations (e.g., HIPAA) • Ability to work independently in a remote environment with demonstrated accountability, consistent output, and responsiveness during scheduled work hours • Exceptional attention to detail and a commitment to accuracy when reviewing and entering claim information • Exposure to claims processing platforms or healthcare operations systems • Ability to work effectively in a remote environment

🏖️ Benefits

• Competitive hourly compensation and equity opportunities • Medical, Dental, and Vision benefits with no waiting period • Paid vacation and company holidays • Company-provided IT equipment (laptop, monitors) • Ongoing opportunities for professional development and career advancement