Claims Representative -Work From Home (Healthcare)

Sagility

2d•$18•Remote

About The Position

Sagility, a global leader in business process management, is dedicated to enhancing the member and patient experience. By combining cutting-edge technology with decades of healthcare expertise, we deliver exceptional results for our clients. If you are detail-oriented, analytical, and thrive in a structured environment, this is your opportunity to build a career in healthcare operations. Sagility is actively building a pipeline of qualified Claims Representatives to support upcoming classes. Early applicants will be prioritized for interview scheduling and for consideration of offers. As a Claims Representative, you will review and process medical, dental, or supplemental insurance claims according to eligibility guidelines, benefits, and internal policies. Our structured training program prepares you for success through instructor-led virtual sessions, hands-on learning, and progressive performance goals. Once training is complete, you will be responsible for meeting established quality, productivity, and accuracy standards. If you are motivated, reliable, and ready to grow your career in healthcare, we encourage you to apply as soon as possible. Become Part of a Team That S.O.A.R,s! S Spark Curiosity O One Team, One Direction A Action for Results R Right by Right Purpose

Requirements

High school diploma or equivalent
Ability to quickly learn new systems and processes
Experience using Microsoft Outlook (email, calendar invites, attachments)
Basic Microsoft Excel skills (sorting/filtering)
Ability to navigate multiple systems using shortcuts and efficient workflows
Strong attention to detail and ability to follow complex procedures
Excellent time management and organizational skills
Ability to meet productivity and quality performance expectations
Experience working independently in a remote environment preferred
Familiarity with healthcare terminology, insurance claims, CPT or ICD-10 coding preferred
Previous claims processing or related administrative experience preferred
Must be at least 18 years of age
Minimum 1 year of consistent employment history (customer service or administrative experience preferred)
Reliable attendance required, especially during the first 90 days
Typing speed of at least 25 WPM
Hardwired internet connection with minimum speeds of 25 Mbps download and 10 Mbps upload
Secure, private workspace free from distractions
Flexible availability, including weekends as business needs require

Nice To Haves

Experience working independently in a remote environment preferred
Familiarity with healthcare terminology, insurance claims, CPT or ICD-10 coding preferred
Previous claims processing or related administrative experience preferred

Responsibilities

Review and process insurance claims accurately using internal guidelines and benefit plans
Research and navigate multiple systems and documents to validate claim details
Confirm required documentation is included and identify missing information
Verify accuracy of medical coding (CPT/ICD-10 preferred)
Evaluate eligibility, coverage, authorizations, and coordination of benefits
Identify discrepancies and resolve errors using established procedures
Maintain productivity and quality standards in a fast-paced environment
Work independently while collaborating with supervisors, coaches, and trainers
Use multiple computer applications and virtual tools such as Outlook, Webex, and internal systems
Continuously improve efficiency through feedback and training support

Benefits

Competitive pay: $18.00/hour
Performance-based incentives
Paid training in a cutting-edge virtual training environment
Comprehensive health coverage (available after 90 days)
Employee wellness and engagement programs.
Career advancement opportunities: 90% of our leaders started as Customer Service Representatives
Daily Pay options available
Medical, Dental, and Vision coverage
Life Insurance
Short-Term and Long-Term Disability options
Flexible Spending Account (FSA)
Employee Assistance Program
401(k) with employer contribution
Paid Time Off (PTO)
Tuition Reimbursement