[Hiring] Health Claims Specialist REMOTE USA

Position: Health Claims Specialist

Date Posted: August 27, 2025

Industry: Healthcare / Insurance

Employment Type: Full Time

Experience: Not Specified

Qualification: High School Diploma or equivalent; Medical Billing and Coding degree/certification preferred

Salary: $13.50/hour + potential bonus up to $1500/month

Location: Austin, TX, United States REMOTE

Company: Sutherland

Description:
Sutherland is seeking a dedicated Health Claims Specialist to join our team in a full-time, permanent capacity. This role focuses on processing medical claims according to client-specific guidelines and is primarily a data entry position. The position is not customer-facing, but accuracy, confidentiality, and adherence to HIPAA regulations are crucial. You will work independently while utilizing available support resources and are expected to meet all performance and quality targets throughout training and ongoing employment.

Key Responsibilities:

• Process medical claims independently for the majority of the workday.
• Accurately adjudicate claims in compliance with company policies, procedures, and regulatory requirements.
• Follow up on claims requiring additional information and refer complex cases to leads or auditors.
• Ensure confidentiality and integrity of all claim information per HIPAA guidelines.
• Utilize specialized software for claims processing.
• May be assigned special projects as needed.

Qualifications & Skills:

• Strong data entry capabilities with excellent attention to detail.
• Effective time management and analytical skills.
• Excellent verbal and written communication skills.
• Proficient in basic computer operations and typing at a minimum of 40 words per minute.
• Previous experience in medical billing, coding, or office settings preferred, with understanding of insurance types including Medicare, Medicaid, and Child Plus.
• Knowledge of medical terminology is required.
• Reliable high-speed internet connection (2 Mbps upload / 10 Mbps download minimum) and a quiet, distraction-free workspace.
• Ability to maintain a clean, paper-free work environment in accordance with company policies.

Benefits & Work Environment:

• Paid training and PTO with flexible vacation options.
• Medical, dental, and vision insurance plans.
• Company-provided equipment for remote work.
• Opportunities for internal advancement, as 80% of frontline leaders are promoted from within.
• Recognition programs, employee discounts, and wellness initiatives including access to a dedicated personal trainer.
• Weekday schedule: Monday – Friday, 8:30 AM – 5:00 PM EST.

Additional Information:
Sutherland is committed to equal employment opportunities and compliance with all EEO guidelines. Employee information is confidential and voluntary disclosure for administrative EEO records will not impact employment decisions.

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