by Terrance Ellis | Dec 12, 2025 | Uncategorized
If you’re the organized, spreadsheet-savvy person who keeps teams from spiraling when new hires start and people roll off, this role will feel like home. You’ll manage provisioning, offboarding, credential issues, and reporting, basically being the quiet backbone that keeps operations moving.
About BroadPath
BroadPath is a work-from-home company supporting healthcare organizations with services that keep operations running smoothly and members supported. They build remote teams focused on quality, speed, and consistency. They also emphasize an inclusive culture that values different backgrounds and perspectives.
Schedule
- Fully remote (United States)
- Schedule details not listed in the posting (expect standard business hours aligned to operations needs)
- Reporting cadence includes daily, weekly, and monthly deliverables
What You’ll Do
- Process new hire IDs and manage offboarding workflows in collaboration with Operations, IT, Recruiting, Training, and Client teams
- Submit, track, and escalate issues related to agent credentials and client access
- Maintain accurate rosters and ensure data stays clean and compliant (including PHI cleanup)
- Track attrition within Salesforce and QuickBase and keep stakeholders informed
- Produce daily, weekly, and monthly reporting to support operations and client needs
- Analyze issues quickly, identify root causes, and communicate solutions with urgency
What You Need
- Intermediate to advanced Microsoft Office skills, with strong emphasis on Excel
- Strong organization, attention to detail, and a sense of urgency in a fast-paced environment
- Strong written and verbal communication skills and comfort coordinating across teams
- Ability to juggle multiple priorities, troubleshoot access issues, and keep work moving without constant supervision
- Familiarity with Windows and common productivity tools (settings, preferences, day-to-day user support)
Benefits
- Work from home
- Cross-functional exposure (Ops, IT, PM, Reporting, Clients, Recruiting)
- Skill growth in provisioning, reporting, and operational support
If you’re strong in Excel and you’ve got that “I can keep ten plates spinning without dropping one” energy, apply now while it’s open.
This is one of those roles that doesn’t get applause, but everything breaks when it’s not done well. You’ll be the reason it doesn’t break.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Dec 12, 2025 | Uncategorized
If you’re an RN who knows UM and appeals and you’re tired of chaos masquerading as “process,” this role is built for precision. You’ll coordinate medical necessity appeals end-to-end, protect member rights, and keep everything compliant, documented, and moving.
About BroadPath
BroadPath is a work-from-home company supporting healthcare organizations with services that keep operations running smoothly and members supported. They build remote teams focused on quality, accuracy, and efficiency. They also emphasize an inclusive culture that values different backgrounds and perspectives.
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 (flexible)
- Note: Some flexibility may be needed for pharmacy-related denials, including evenings/weekends
- Pay: Up to $50/hour, paid weekly
What You’ll Do
- Coordinate clinical evaluation and processing of medical necessity appeals with clinical reviewers, medical directors, physician reviewers, and network providers/facilities
- Ensure compliance with HHSC and applicable regulatory/accreditation standards, including timeliness, documentation, and member/provider notification requirements
- Partner with physician teams on denial categories, guideline citations, and appropriate responses to support consistent decision-making
- Manage EMR and Fair Hearing workflows, including coordinating requests through TIERS when requested by Members/LARs or providers
- Oversee accurate documentation and recordkeeping across electronic/event tracking systems, including appeal determination letters
- Provide education and training support for clinical reviewers (nurses/therapists), including creating training examples and updates as processes change
- Conduct audits and support corrective action planning; assist with appeal file preparation for NCQA reviews
- Analyze quarterly appeal trends and produce internal and state-required reporting, ensuring timely HHSC submissions to avoid penalties
- Advocate for continuity of care needs, including out-of-network authorization approvals when appropriate
What You Need
- Active Texas RN license or compact RN license
- 3+ years nursing experience
- 1+ year Utilization Management and Appeals experience
- Strong written, verbal, and computer skills with excellent documentation habits
- Ability to work independently and stay organized in a remote environment
- Team-first mindset with strong stakeholder communication (providers, members/LARs, internal clinical teams)
Benefits
- Work from home
- Weekly pay
- Competitive pay (up to $50/hour)
- Consistent weekday schedule with flexibility during production
These roles don’t stay open long when they’re paying top-of-range. If you’ve got UM + appeals experience and the license piece, move on it.
This is impact work: you’re protecting due process, keeping care decisions defensible, and making sure people aren’t getting lost in the system.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Dec 12, 2025 | Uncategorized
If you’ve got claims experience and you like being the person who can spot what’s wrong fast and fix it clean, this role fits. You’ll adjudicate routine and complex medical claims, resolve issues for providers and members, and help keep claims operations accurate and moving, all from home.
About BroadPath
BroadPath is a work-from-home company supporting healthcare organizations with services that keep operations running smoothly and members supported. They build remote teams focused on accuracy, efficiency, and consistency. They also emphasize an inclusive culture that values different backgrounds and perspectives.
Schedule
- Fully remote (United States)
- Training: 5 days, Monday–Friday, 8:00 AM–5:00 PM PST
- Production: Monday–Friday, 8:00 AM–5:00 PM PST
- No weekends
- Pay: $17/hour, paid weekly
What You’ll Do
- Adjudicate routine and complex claims, resolving edits and audits for hardcopy and electronic submissions
- Communicate with providers and members to resolve issues tied to claims, eligibility, and authorizations
- Generate emergency reports and authorizations for claims missing prior approval
- Process third-party liability and coordination of benefits claims according to policy
- Assist with stop loss report review and flag members nearing reinsurance thresholds
- Escalate potential system programming issues to supervisors
- Support and train less experienced claims processors
- Route carved-out service claims based on plan contract rules
- Apply plan contract knowledge (pricing, eligibility, referrals/auths, benefits, capitation) to ensure accurate processing
- Coordinate with Accounting to ensure claims post correctly to general ledger accounts
- Partner with Customer Service and Provider Services on large-claim projects and adjustments
- Interpret benefits and plan details using the cut-log system when needed
- Assist senior examiners with complex claim adjustments and complete other assigned tasks
What You Need
- High school diploma or equivalent
- 1–3 years of medical claims processing experience
- Medicare claims experience
- Knowledge of ICD-9, CPT, HCPC, and revenue coding
- Strong analytical and problem-solving skills in a production environment
- Strong communication and customer service skills for provider/member interactions
- Detail-oriented with the ability to stay focused in high-volume work
- Proficiency with claims processing software and technology
- Understanding of medical terminology, coding, and healthcare regulations
- Ability to learn and apply complex claims procedures and policies
- Team-oriented and comfortable supporting/training others
- Systems experience: QXNT
Benefits
- Work from home
- No weekends
- Weekly pay
- Consistent weekday schedule (PST hours)
If you meet the Medicare + coding piece, don’t sit on this one. Remote claims roles like this tend to close once a class fills.
You’ll be the difference between a claim stuck in limbo and a claim resolved the right way.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Dec 12, 2025 | Uncategorized
If you’re steady, accurate, and you like clean rules and clear outcomes, this one’s a solid remote lane. You’ll process simple to moderately complex Medicaid claims and help keep turnaround times smooth without sacrificing quality.
About BroadPath
BroadPath is a work-from-home company supporting healthcare organizations with services that keep operations running smoothly and members supported. They build remote teams focused on accuracy, efficiency, and consistency. They also emphasize an inclusive culture that values different backgrounds and perspectives.
Schedule
- Fully remote (United States)
- Training: 1 week, Monday–Friday, 8:00 AM–5:00 PM Arizona time
- Production: Monday–Friday, 8:00 AM–5:00 PM Arizona time
- No weekends
- Pay: $18/hour, paid weekly
What You’ll Do
- Process incoming Medicaid claims according to client policies, procedures, and established guidelines
- Verify required data fields are complete and confirm medical records are included and reviewed when needed
- Refer claims for medical claim review when appropriate
- Work efficiently in a virtual environment while maintaining accuracy and pace
What You Need
- 2+ years of recent health insurance claims processing experience
- Ability to balance production goals and quality standards consistently
- Ability to uphold confidentiality and maintain a professional business image
- Reliable, positive, and comfortable working independently from home while collaborating with a team
Benefits
- Work from home
- No weekends
- Weekly pay
- Short training period (1 week)
Hiring can move quickly for remote claims roles. If you’ve got recent claims experience and you’re ready to lock in a weekday schedule, apply while it’s still open.
This is one of those roles where being consistently right matters more than being flashy. If you’re built for that, you’ll do well here.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Dec 12, 2025 | Uncategorized
If you’re the person people hand the messy, high-dollar claims to because you actually know how to untangle them, this is your lane. You’ll adjudicate complex claims end-to-end and help keep accuracy, compliance, and turnaround time on point, all from home.
About BroadPath
BroadPath is a work-from-home company supporting healthcare organizations with services that keep operations running smoothly and members supported. They build remote teams focused on quality, speed, and consistency. They also emphasize an inclusive culture that values different backgrounds and perspectives.
Schedule
- Fully remote (United States)
- Training: 5 days, Monday–Friday, 8:00 AM–5:00 PM PST
- Production: Monday–Friday, 8:00 AM–5:00 PM PST
- No weekends
- Pay: $18/hour, paid weekly
What You’ll Do
- Adjudicate complex claims (hardcopy and electronic), resolving edits and audits
- Resolve provider and eligibility issues tied to incoming claims
- Generate emergency reports and authorizations when prior auth is missing
- Process third-party liability and coordination of benefits claims per policy
- Review stop loss reports and flag members nearing reinsurance thresholds
- Identify possible system programming issues and escalate to leadership
- Provide technical support and training to claims processors and peers
- Route carved-out service claims appropriately based on plan contracts
- Apply plan contract knowledge, provider pricing, eligibility, referrals, benefits, and capitation rules to ensure accurate processing
- Ensure claims post correctly to the appropriate general ledger accounts
- Partner with Customer Service and Provider Services on large-claim projects, adjustments, and escalations
- Assist with benefits and plan interpretation using the cut-log system
- Adjust complex claims and support other examiners with resolution work
- Handle additional tasks as assigned
What You Need
- High school diploma or equivalent
- 2+ years experience processing regular and complex medical claims
- Proficiency in ICD-9, CPT, HCPC, and revenue coding
- Strong knowledge of complex claims procedures and medical terminology
- Ability to troubleshoot independently and resolve complex claim issues
- Comfort working in a high-volume, production-driven environment
- Strong focus, detail-orientation, and accuracy under strict quality standards
- Technical proficiency with claims processing software
- Knowledge of HEDIS, DOC, HCFA, and NCQA requirements
- Ability to serve as a go-to resource and trainer for claims processors
Benefits
- Work from home
- No weekends
- Weekly pay
- Consistent weekday schedule (PST hours)
These remote healthcare roles can fill quickly. If you’ve got the coding knowledge and complex claims experience, get your resume in while it’s open.
This is the kind of role where your accuracy protects both the plan and the patient. If you like being the fixer, you’ll fit right in.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Dec 12, 2025 | Uncategorized
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…
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