Home
/
Comprehensive
/
Health Claims Specialists- Remote
Health Claims Specialists- Remote-November 2024
Hagatna
Nov 15, 2025
About Health Claims Specialists- Remote

About Sutherland

Artificial Intelligence. Automation.Cloud engineering. Advanced analytics.For business leaders, these are key factors of success. For us, they’re our core expertise.

We work with iconic brands worldwide. We bring them a unique value proposition through market-leading technology and business process excellence.

We’ve created over 200 unique inventions under several patents across AI and other critical technologies. Leveraging our advanced products and platforms, we drive digital transformation, optimize critical business operations, reinvent experiences, and pioneer new solutions, all provided through a seamless “as a service” model.

For each company, we provide new keys for their businesses, the people they work with, and the customers they serve. We tailor proven and rapid formulas, to fit their unique DNA.We bring together human expertise and artificial intelligence to develop digital chemistry. This unlocks new possibilities, transformative outcomes and enduring relationships.

Sutherland

Unlocking digital performance. Delivering measurable results.

This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator determines how much money will be paid after an insurance claim has been examined. This is not a customer service or customer facing position. This is a data entry position where you will be processing medical claims per the specific client requirements. Claims can vary and are highly customized depending on the service level. You will work independently with the assistance of knowledge base and support personnel. You will also be expected to meet all Key Performance Indicators and Quality goals throughout Training and beyond.

What you will be doing as a Claims Examiner:

Work independently, processing claims via data entry for 90% of your day.

Be responsible for effectively adjudicating claims to meet production, quality, and other metrics in accordance with policy/procedures and regulatory guidelines

Follow up on claims needing additional information

Refer problem claims to a Lead and/or auditor for additional review

Make sure that the integrity of the information is accurate and kept private according to HIPPA guidelines

Work with specific software

May be assigned special projects

We offer:

Salary of $13.50/hour + monthly incentives up to $1500/month

Monthly rewards recognition programs

Medical, dental and vision benefits

Paid training PTO

Cross program and advancement opportunities – 80% of our frontline leaders have been promoted from within

Employee Discounts

EAP Health and Wellness programs including a personal trainer dedicated to Sutherland

Health or health insurance claims experience

Knowledge of medical terminology

Some experience in a medical office

Accurate typing of 40 WPM

We will provide equipment, however to work from home, you must have:

Excellent Internet connectivity:

Internet access speeds of 2 Mbps upload and 10 Mbps download – the faster the better!

In-house network, and a hard-wired Internet connection capable of continuously supporting outstanding call quality and high-speed response rates. (wireless and/or satellite Internet Service Providers are not compatible with our systems)

A quiet and distraction-free, secure place to work.

IMPORTANT NOTE : This job is open only to residents of the United States, and you must be authorized to work in the US in order to be considered for employment.

About Us

Sutherland, recently recognized as a Great Place to Work in the US, is a digital transformation company, making digital processes feel more human for the customers that we serve. We have been helping customers globally, across industries from financial services to healthcare, entertainment to retail, insurance to gaming, and everything in between, provide exceptional experiences for their customers for over 35 years.

EEOC and Veteran Documentation

During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.

At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all

Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.

Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.

EEOC and Veteran Documentation

During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.

At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all

Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.

Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
Air Quality Engineer 4
36706BR Requisition ID: 36706BR Business Unit: TSU Job Description: We are currently seeking a Mid-level Air Quality Engineer to support a wide variety of projects. We will consider applicants on the
Director Growth, Cloud Professional Services, Salesforce Practice (East Coast & West Coast)
Join our growing Cloud Services Organization. At Acxiom, our people are the single most important driver of success. Our teams work at the forefront of data analytics and advanced technology solution
RN Long Term Care (LTC)
...
Demi Chef De Partie
Job Number 24012957 Job Category Food and Beverage & Culinary Location The Ritz-Carlton Pune, Golf Course Square, Pune, Maharashtra, India Schedule Full-Time Located Remotely? N Relocation? N Pos
Retail Operations Manager (Retail Sales Manager)
​​ Job Title: Retail Sales Manager ​ Who we are: As one of the largest for-profit thrift operators in the United States, Canada and Australia for value priced pre-owned clothing, accessories and hous
SLH Multiple Modality Radiologic Technologist
SLH Multiple Modality Radiologic Technologist San Leandro, CA San Leandro Hospital SLH Radiology Diagnostic Full Time - Night Allied Health Req #:38639-28304 FTE:1 Posted:January 22, 2024 Summary SUM
Vans Sales Associate (Scottsdale Quarter, Scottsdale, AZ)
Sales Associate As one of our passionate, fun and dedicated Sales Associates, you will be the voice of our brand while elevating the consumer experience through genuine consumer connections and selli
Retail Banker I (30hrs) BIL English | Spanish Preferred
430742BR Job Title: Retail Banker I (30hrs) BIL English | Spanish Preferred Company Overview: Our Values At TD, we're guided by our purpose to enrich the lives of our customers, communities and colle
Workforce Management Adherence Clerk
About Conduent: Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes
Mechanical Design Engineer
...
Copyright 2023-2025 - www.zdrecruit.com All Rights Reserved