Health Claims Specialist

Sutherland

Claims Adjudicator processing medical claims for healthcare company. Independent data entry position focusing on accuracy and compliance with quality goals.

Posted 5/23/2026full-timeRemote • Kentucky • 🇺🇸 United StatesMid-LevelSenior💰 $14 per hourWebsite

About the role

Key responsibilities & impact

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.

Requirements

What you’ll need

High School Diploma or equivalent
Excellent Internet Connectivity: Internet access speed of 2 Mbps upload and 10 Mbps download – the faster the better.
A quiet and distraction-free, secure place to work.
Effective verbal and written communication skills.
Strong typing and analytical abilities.
Multi-tasking skills with a strong attention to detail.
Computer knowledge.
Minimum 40 words per minute on typing test.
Must have and maintain a clean and paper free work environment to meet our company policies.
Medical Billing and Coding degree/certification.
Previous experience in a medical office type setting, including some knowledge of insurance, claims, billing or coding, with an understanding of the different types of insurance (Medicare/Medicaid and/or Child Plus).
Knowledge of Medical terminology.

Benefits

Comp & perks

Medical, dental, and vision plans.
Paid training and PTO (be sure to ask about our Global Flexible Vacation Policy).
Company-provided equipment.
Advancement opportunities – 80% of our frontline leaders have been promoted from within.
Monthly rewards & recognition programs.
Employee Discounts.
EAP and Health and Wellness programs including a personal trainer dedicated to Sutherland.
Weekday schedule, Monday – Friday 8:30 AM – 5:00 PM EST.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

data entryadjudicating claimstyping speed 40 wpmanalytical abilitiesmedical billingmedical codinginsurance knowledgeclaims processingattention to detailcomputer knowledge

Soft Skills

effective communicationmulti-taskingindependent workproblem-solvingattention to detail

Certifications

High School DiplomaMedical Billing and Coding certification