Claims Processor III - Remote

Norfolk, VA • Multiple shifts available

About the role

Sentara Health Plan is hiring a full-time, permanent (40 hours/week) Claims Processor III. This is a remote position available to candidates located in Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, or Wisconsin.

Responsibilities

• Handle all areas of customer service related to the acquisition and retention of members for Sentara Health Plan, Inc.
• Administer group information, process claims, and interact with members, providers, and employers.
• Meet or exceed current claims processing standards, including financial, check, and processing accuracies.

Requirements

• High School diploma or equivalent (required).
• One of the following certifications or experience:
  • CPC Certification, or
  • Related Medical Certification, or
  • 5 years of direct claims processing experience, or
  • Associate’s degree or higher.
• Minimum of 18 months of claims processing experience.
• 2 years of administrative experience (required).
• 2 years of customer service experience (required).
• 2 years of health plan claims disbursements experience (required).

About Sentara Health Plan

Sentara Health Plans provides health plan coverage to nearly one million members in Virginia. We offer a full suite of commercial products, including employee-owned and employer-sponsored plans, Individual & Family Health Plans, Employee Assistance Programs, and plans serving Medicare and Medicaid enrollees. Our quality provider network includes specialists, primary care physicians, and hospitals. We provide programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all aimed at improving member health.

Benefits

• Medical, dental, and vision plans.
• Adoption, fertility, and surrogacy reimbursement up to $10,000.
• Paid time off and sick leave.
• Paid parental and family caregiver leave.
• Emergency backup care.
• Long-term, short-term disability, and critical illness plans.
• Life insurance.
• 401k/403B with employer match.
• Tuition assistance – $5,250/year and discounted educational opportunities through Guild Education.
• Student debt pay down – $10,000.
• Pet insurance.
• Legal resources plan.
• Opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria are met.