Claims Examiner

Location: Chicago, IL

About Nara

Nara is an AI-native benefits administrator (TPA) fixing healthcare benefits by designing and administering personalized, cost-effective health plans for employers, employees, and their families. Our mission is to rebuild health care around people, not the system. We're working toward a future where coverage and care are affordable, accessible, and understandable. To get there, we're rebuilding the system from the ground up, using new data, tools, and technology in service of human judgment, not in place of it. When we succeed, people get the right care, at an optimal price, without the friction.

The Role

You'll process and adjudicate health, dental, and vision claims with the accuracy and judgment that comes from real experience, while also helping us get smarter about how claims get handled. Every claim you review, correct, or flag becomes an input: patterns you catch, edge cases you resolve, and documentation you write all feed directly into improving our AI-enabled platform. This is claims processing where your expertise shapes the system, not just keeps it running.

Key Responsibilities

• Process and adjudicate health, dental, and vision insurance claims
• Perform quality assurance reviews of auto-adjudicated claims to ensure accuracy and identify areas for improvement
• Analyze claim documentation to ensure accuracy, completeness, and compliance with plan benefits
• Collaborate with our technology team to identify patterns and opportunities for automation
• Share claims processing expertise with team members and contribute to knowledge base development
• Participate in the continuous improvement of our claims processing workflows
• Document best practices and unusual case resolutions

Requirements

• 5+ years of experience in TPA health insurance claims processing
• Strong proficiency with spreadsheet software (Excel, Google Sheets)
• Experience using multiple software systems simultaneously, including claims processing software systems
• Proven ability to identify patterns and edge cases in claims processing
• Strong logical thinking and structured problem-solving approach
• Experience creating detailed process documentation
• Excellent written and verbal communication abilities
• Demonstrated ability to work independently and manage time effectively

Nice to Have

• Background in benefits administration or medical billing
• History of implementing process improvements
• Comfort with rapid technological change and evolving workflows
• Interest in AI and its applications in healthcare and insurance

Schedule

• Full-time position
• Consistent daily schedule preferred, but flexibility available

What We're Looking For

We value how you think and approach problems as much as what you've done.

Ownership Mentality. When you take on something, you own it end-to-end until it's done, not just until it's someone else's turn. If you spot a friction point, you fix it rather than flag it and move on. When a claim doesn't fit the standard pattern, it's yours to work through to a correct resolution, not to punt to someone else's queue.

Learning Velocity. You teach yourself what you need to know quickly, digging into documentation and testing rather than waiting to be shown. When a new plan design or auto-adjudication rule rolls out, you dig into it yourself and know how it should behave before it starts generating edge cases.

Systems Awareness. You see how your work connects to everything around it, and you build with the full lifecycle in mind, not just the task in front of you. You don't just fix a misadjudicated claim, you trace why the auto-adjudication logic got it wrong and flag it as a pattern worth fixing upstream.

Clarity in Communication. You make complex things simple for whoever is listening, translating technical detail into plain language and vague asks into concrete requirements. Your documentation of an unusual case resolution is clear enough that the next person who hits it doesn't have to start from scratch.

Bias for Action. You move with urgency on what you control and don't wait for perfect information to make a decision. When you spot a recurring error before anyone's raised it as a problem, you write it up and bring it to the technology team rather than waiting to be asked.

Teammate Mentality. You show up for the people around you, not just your own workload, and you'd want to be in a foxhole with the people you work with. When you find a faster way to resolve a category of claims, you share it with the team instead of quietly keeping the efficiency to yourself.

Benefits

• Competitive salary and equity options
• Health insurance with company subsidy
• Unlimited PTO policy
• Equipment budget for your home office and travel needs
• Regular team retreats and offsites

Interview Process

• Application Review
• Initial Call (45 minutes) with a Claims Operations leader to review your background and tell you about Nara
• Exercise & Team Interview (60 minutes) with multiple Nara team members - you'll work through sample claims scenarios
• Final Interview (30 minutes) with a member of the leadership team to determine if we're a mutual fit

Nara is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.