If you know health plan operations and you’re the kind of person who can calm a situation down while still moving it forward, this role is for you. You’ll be the guide and advocate for members navigating appeals, external medical reviews, and fair hearings, all from home.
About BroadPath
BroadPath is a work-from-home company supporting healthcare organizations with services that help members get the support they need. They focus on delivering high-quality customer experiences and building teams that can perform remotely, at scale. They also emphasize an inclusive culture where different backgrounds and perspectives are valued.
Schedule
- Fully remote (United States)
- Training: 2 weeks, Monday–Friday, 8:00 AM–5:00 PM CST
- Production: Monday–Friday, 8:00 AM–5:00 PM CST
- No weekends
- Pay: Up to $22/hour, paid weekly
What You’ll Do
- Support and advocate for members through the appeals process, External Medical Review, and State Fair Hearing, clearly explaining rights, next steps, and timelines
- Coordinate resolutions with internal teams (Claims, Eligibility, Provider Relations, Business Ops) while managing escalations and meeting service level expectations
- Translate and interpret communications between English and Spanish, ensuring accuracy and cultural awareness
- Initiate and manage EMR and Fair Hearing workflows using TIERS (HHSC Intake Portal), track compliance, and ensure documentation is submitted on time
- Support Utilization Management admin work by collecting member/provider info and applying knowledge of medical terminology and coding (ICD-10, CPT, HCPCS)
- Contribute to quality improvement efforts by spotting trends, recommending process improvements, and participating in projects/committees
What You Need
- High school diploma or equivalent
- 4+ years of foundational Utilization Management experience
- Understanding of health plan operations, claims and eligibility systems, claims processing, and healthcare benefits
- Familiarity with Texas Department of Insurance and HHSC rules related to complaints and appeals
- Strong customer service skills, professional phone presence, and ability to work independently in a remote environment
- Strong attention to detail, multitasking ability, and problem-solving skills
- Medical terminology knowledge
- Spanish-English bilingual ability for translation/interpretation (as listed in responsibilities)
Benefits
- Work from home
- No weekends
- Weekly pay
- Competitive hourly pay (up to $22/hour)
Roles like this can move fast when hiring ramps up. If this matches your background, get your resume ready and apply while the posting is still fresh.
You’re not just processing cases here. You’re helping people understand their options, protect their care, and feel less lost in the system.
Happy Hunting,
~Two Chicks…