Job Details

Explore meaningful roles that let you make an impact in healthcare while growing your career with purpose, innovation, and global opportunities.Claims Representative -Work From Home (Healthcare)About SagilitySagility combines industry-leading technology and transformation-driven BPM serviceswith decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.Job title: Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.Job Title: Claims Representative -Work From Home (Healthcare)Job Description: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!SSpark CuriosityOOne Team, One DirectionAAction for ResultsRRight by Right PurposeBenefits You Will EnjoyCompetitive pay: $18.00/hourPerformance-based incentivesPaid training in a cutting-edge virtual training environmentComprehensive health coverage (available after 90 days)Employee wellness and engagement programs.Career advancement opportunities: 90% of our leaders started as Customer Service RepresentativesWhat You Will DoReview and process insurance claims accurately using internal guidelines and benefit plansResearch and navigate multiple systems and documents to validate claim detailsConfirm required documentation is included and identify missing informationVerify accuracy of medical coding (CPT/ICD-10 preferred)Evaluate eligibility, coverage, authorizations, and coordination of benefitsIdentify discrepancies and resolve errors using established proceduresMaintain productivity and quality standards in a fast-paced environmentWork independently while collaborating with supervisors, coaches, and trainersUse multiple computer applications and virtual tools such as Outlook, Webex, and internal systemsContinuously improve efficiency through feedback and training supportWhat You BringHigh school diploma or equivalentAbility to quickly learn new systems and processesExperience using Microsoft Outlook (email, calendar invites, attachments)Basic Microsoft Excel skills (sorting/filtering)Ability to navigate multiple systems using shortcuts and efficient workflowsStrong attention to detail and ability to follow complex proceduresExcellent time management and organizational skillsAbility to meet productivity and quality performance expectationsExperience working independently in a remote environment preferredFamiliarity with healthcare terminology, insurance claims, CPT or ICD-10 coding preferredPrevious claims processing or related administrative experience preferredJob RequirementsMust be at least 18 years of ageMinimum 1 year of consistent employment history (customer service or administrative experience preferred)Reliable attendance required, especially during the first 90 daysTyping speed of at least 25 WPMHardwired internet connection with minimum speeds of 25 Mbps download and 10 Mbps uploadSecure, private workspace free from distractionsFlexible availability, including weekends as business needs requireBenefits & PerksDaily Pay options availableMedical, Dental, and Vision coverageLife InsuranceShort-Term and Long-Term Disability optionsFlexible Spending Account (FSA)Employee Assistance Program401(k) with employer contributionPaid Time Off (PTO)Tuition ReimbursementSagility is an Equal Opportunity Employer/Veteran/Disability.Alert: Please beware of fraudulent communications from profiles impersonating Sagility or its employees. All official communication from Sagility will come from our verified email domains: “@sagility.com” or “@sagilityhealth.com”. Sagility will never ask for payments for job offers, interviews, or otherwise. Do not respond to suspicious communications, whether via email, WhatsApp, or any social platform. For any concerns, contact us directly through our official website.Location: Work@Home USA United States of AmericaJoin our team, we are looking forward to talking to you!#J-18808-Ljbffr