---
title: 'Claims Examiner at Point C'
canonical: 'https://feeny.ai/job/claims-examiner-point-c-bellingham-94qfz99g5m62'
type: 'job'
last_seen: '2026-09-11'
---

# Claims Examiner at Point C

- **Company:** Point C
- **Location:** Bellingham, WA
- **Compensation:** $19–$22/hr
- **Posted:** 2026-08-21
- **Last confirmed live:** 2026-09-11
- **Apply:** https://job-boards.greenhouse.io/pointc/jobs/5386621008

## Job description

[Point C](https://pointchealth.com) is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.

Point C is looking for a detail-oriented and motivated Claims Examiner to join our team. In this role, you’ll be responsible for accurately processing medical claims while ensuring compliance with plan documents, policies, and industry regulations. The ideal candidate is analytical, organized, and experienced in self-funded or third-party administration environments.

Primary Responsibilities

- Adjudicate new claims and process adjustments, including denials upon receipt of additional information
- Review and resolve appeals and subrogation/third-party liability cases
- Manage individual inventory to ensure timely turnaround and production goals are met
- Ensure claims are processed in accordance with stop loss contract terms
- Respond to internal and external inquiries via email and other channels within established timeframes
- Follow up on missing or incomplete information to ensure claims can be accurately processed
- Maintain minimum production, financial, and procedural accuracy standards on a monthly basis

## Qualifications

- Experience with Third Party Administrator (TPA) or self-funded claims administration preferred
- At least 2+ years of experience in insurance claims processing required
- Experience reviewing and finalizing claim payments for accuracy in accordance with plan policies
- Ability to interpret and apply plan documents to ensure accurate claims adjudication
- Demonstrated understanding of both claim review processes and underlying benefit plan design
- Experience with HealthPac, El Dorado, Javelina, or VBA systems preferred
- Working knowledge of CPT and ICD-10 coding
- Basic understanding of medical terminology
- Strong communication and customer service skills
- Proficiency in Microsoft Office and general computer applications
- Ability to maintain confidentiality and comply with all company policies and procedures
- Able to work independently with minimal supervision
- Ability to prioritize, multitask, and work overtime as needed
- Associate Degree Preferred

Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role.

Pay Transparency $19—$22 USD

Benefits:

- Comprehensive medical, dental, vision, and life insurance coverage
- 401(k) retirement plan with employer match
- Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)

- Paid time off (PTO) and disability leave

- Employee Assistance Program (EAP)

Equal Employment Opportunity: At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.

## About Point C

## Company Overview
- **One-liner**: Point C is a national independent Third-Party Administrator (TPA) that designs and administers self-funded health plans through an integrated model of administration, clinical support, and partner coordination.
- **Entity Type**: Private (Venture-backed; raised a Venture Round in November 2024 led by Shore Capital Partners)
- **Headquarters**: Chicago, Illinois, United States
- **Founded**: Not publicly available (leadership team has 40+ years of combined experience; company has been in business for decades)
- **Founders**: Not publicly available

## Core Business
- Primary industry: Healthcare Administration / Third-Party Administration (TPA) / Health Plan Services
- Target customers: Brokers and employers (self-funded health plans); B2B, primarily mid-market and enterprise
- Mission or purpose statement: "Drive value and reduce costs for our customers by thoughtfully administering benefit plans and providing innovative cost containment solutions."

## Products & Services
- **Self-Funded Health Plan Administration**: Full-service claims administration, eligibility management, compliance coordination, account management, and plan operations for self-funded employer groups.
- **Clinical Integration & Cost Containment**: Clinical guidance and pharmacy insight built into the model to reduce unnecessary spend and strengthen the member experience.
- **Data Transparency & Reporting**: Clear reporting and plan insights that help brokers and employers understand cost drivers, track performance, and act with confidence.
- **Consumer-Directed Benefits Support**: Support for HSAs, HRAs, and other consumer-directed benefit programs.
- **High-Touch Customer Service**: Responsive, hands-on support for brokers, employers, and members, with real people helping plans run smoothly.

## Market Standing
- **Valuation/Market Cap**: Not disclosed (private company)
- **Key Metric**: Annual Revenue estimated at $1.0M–$5.0M (LinkedIn estimate); supports 100k+ employee lives and 650+ employer groups; 6 offices coast-to-coast
- **Notable Investors/Partners**: Shore Capital Partners (lead investor in 2024 venture round); independent board includes leaders from Optum, Navia Benefit Solutions, Centivo, and HPOne
- **Growth Signals**: 124 employees (+111.9% YoY, +94 people); LinkedIn followers grew 44.7% YoY; actively hiring across multiple departments (Account Management, Operations, Data Science, Finance, Sales, Claims)

## Competitive Advantages
- **Independent TPA Model**: Unlike many TPAs that are owned by carriers or large health systems, Point C is independent, allowing strategies to be shaped purely around client needs.
- **Integrated Operating Model**: Combines administration, clinical programs, reporting, and vendor coordination into one connected structure, reducing fragmentation common in self-funded plans.
- **National Scale with Local Service**: Operates 6 offices coast-to-coast while maintaining a service approach built around responsiveness and regional presence.
- **Deep Leadership Expertise**: Executive team with decades of experience from Optum, Coventry, and other major health plan organizations.

## Strategic Focus
- **Growth & Expansion**: Scaling the team aggressively (+111% headcount YoY) and expanding national presence.
- **Technology & Data**: Investing in data science, AI, and healthcare informatics (multiple AI intern roles posted) to enhance transparency and decision-making.
- **Member Experience**: Ongoing focus on improving the member experience across the healthcare journey.
- **Integrated Value Delivery**: Continuing to refine the connected model that aligns administration, clinical support, and partner coordination.

## Why Work Here
- **Remote-First Culture**: Nearly all roles listed as "United States - Remote" (with some in-person roles in Bellingham, WA and New York).
- **Growth Trajectory**: Rapidly scaling company (124 employees, up 111% YoY) with significant career advancement opportunities.
- **Meaningful Impact**: Work that carries "real operational and human impact" in healthcare.
- **Culture Values**: Accountability, collaboration, transparency, integrity, and thoughtful execution.
- **Hiring Activity**: Actively recruiting across Account Management, Operations, Data Science, Finance, Sales, and Claims.
- **Team Size**: Small enough for individual impact, large enough for national reach.

## Sources
1. [pointchealth.com](https://pointchealth.com/)
2. [pointchealth.com/about](https://pointchealth.com/about)
3. [pointchealth.com/about/leadership](https://pointchealth.com/about/leadership)
4. [job-boards.greenhouse.io/pointc](http://job-boards.greenhouse.io/pointc)
5. [linkedin.com/company/point-c](https://www.linkedin.com/company/point-c)

## Other roles at Point C

- [Director, Client Services](https://feeny.ai/job/director-client-services-point-c-united-states-4pat37c325kc) — United States
- [Sales Director, West](https://feeny.ai/job/sales-director-west-point-c-united-states-5fb49rv1t938) — United States
- [CDP Flex Customer Service Representative](https://feeny.ai/job/cdp-flex-customer-service-representative-point-c-united-states-vz6ydyqteq19) — United States
- [VP, Insights and Analytics](https://feeny.ai/job/vp-insights-and-analytics-point-c-united-states-h621mqb8ken8) — United States
- [Senior Manager, Stop Loss Filling](https://feeny.ai/job/senior-manager-stop-loss-filling-point-c-united-states-017fp7wm1bv3) — United States
- [Zendesk Product Owner - Configuration Administrator](https://feeny.ai/job/zendesk-product-owner-configuration-administrator-point-c-united-states-pajgts48vsgq) — United States
- [Account Manager](https://feeny.ai/job/account-manager-point-c-united-states-8eqf9m10f0k4) — United States
- [Claims Examiner](https://feeny.ai/job/claims-examiner-cottingham-butler-dubuque-iowa-766qcmv1tcz9) — Dubuque Iowa, United States