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…