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Associate Claims Representative
Sanford HealthClaims Representative at Sanford Health responsible for processing health insurance claims accurately and efficiently. Validates claims and ensures compliance with health insurance guidelines.
Posted 6/20/2026full-timeRemote • Minnesota, North Dakota, South Dakota • 🇺🇸 United StatesJuniorMid-LevelWebsite
About the role
Key responsibilities & impact- Responsible for processing health insurance claims submitted via paper or electronically by providers and members
- Validates health insurance claims with an understanding of health insurance cost sharing, limitations, and exclusions
- Reviews claims for completeness and accuracy
- Releases health insurance claims for payment according to the defined workflows
- Works assigned pend and error reports
- Determines benefit level to be paid according to the summary plan language
- Responds promptly to requests for information from other Sanford Health Plan departments
- Refers complex claims to Senior and/or Lead Claims Representatives.
Requirements
What you’ll need- High school diploma or equivalent required
- Some college level course work preferred
- One year of applicable experience required
- A minimum of one year of medical claims processing experience is preferred
- Basic knowledge of Microsoft Office
Benefits
Comp & perks- Health insurance
- Retirement plans
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
health insurance claims processingclaims validationclaims reviewpayment releaseerror report managementbenefit level determination
Soft Skills
communicationresponsivenessattention to detail