Nonstop Administration & Insurance Services · 3 hours ago
Substantiation Analyst
United States
Full-time
Remote
Entry, Mid Level
$28.85/hr - $28.85/hr
2+ years expNonstop Administration and Insurance Services, Inc. is a fast-growing health insurance company committed to making high-quality, affordable healthcare accessible to everyone. They are seeking a detail-oriented Substantiation Analyst to review and resolve substantiation tickets, guide members through the documentation process, and ensure compliance with healthcare regulations and company policies.
FitnessHealth CareWellness
No H1B
Responsibilities
Resolve substantiation tickets promptly with professionalism and clarity, providing high-level customer service through written and verbal communication
Maintain accurate, thorough case notes and escalate issues to leadership when appropriate
Work effectively in a fast-paced, remote work environment with high-volume ticket traffic
Demonstrate expert understanding of healthcare coverage, including in-network and out-of-network services, provider eligibility, and service classifications
Review and explain Explanation of Benefits (EOBs), provider billing statements, and other medical documentation
Occasionally coordinate with medical carriers and provider billing departments to resolve claim discrepancies
De-escalate difficult member situations by offering calm, empathetic, and solutions-focused support
Ensure all interactions reflect a commitment to member satisfaction and positive outcomes
Build trust and foster positive relationships by going above and beyond for members
Adhere strictly to HIPAA and confidentiality policies, as well as internal processes and compliance standards
Engage in ongoing training and professional development to stay current on healthcare trends and substantiation best practices
Qualification
Required
2+ years of experience in healthcare claims, substantiation, insurance, or medical billing preferred
Strong knowledge of EOBs, medical terminology, and insurance processes
Strong attention to detail and accuracy in documentation
Proven ability to manage multiple tasks and meet deadlines in a high-volume environment
Experience working with sensitive health information in accordance with HIPAA
Commitment to high-quality customer service and member advocacy
Tech-savvy with the ability to learn and navigate internal systems and ticketing tools
Strong communication skills—verbal and written
Ability to work independently and in a collaborative, remote environment
Problem-solving and critical thinking skills
Preferred
Proficient with Google Suite products (Sheets, Docs, etc.) or equivalents
Familiarity with medical insurance and medical benefits
Bachelor's degree preferred; equivalent experience considered
Applies critical thinking and balanced judgment to solve problems and drive confident decisions
Must demonstrate proficiency in AI-driven tools and solutions to improve processes, optimize performance, and support continuous innovation
Benefits
Health, fully covered: 100% of medical, dental, and vision premiums for you and your dependents
Fully remote position
Technology allowance
Flexible PTO and holidays
Financial wellness: 401(k) match
Company
Nonstop Administration & Insurance Services
With Nonstop Health, organizations with over 50 members on healthcare benefits save an average of 12.5% on their healthcare spend – savings for both the employer and employee.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Paymon Farazi
CEO
Recent News
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