Support the World Trade Center Health Program through accurate, detail-driven claims processing.
About Broadway Ventures
Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) specializing in program management, advanced technology solutions, and innovative consulting. We partner with government and private sector clients to improve operations, strengthen infrastructure, and deliver long-term, sustainable success. Our team is built on integrity, collaboration, and a commitment to excellence.
In this role, you’ll support the World Trade Center Health Program by applying your expertise in medical claims processing to ensure accuracy, compliance, and timely resolution. Your work directly contributes to the health and wellbeing of individuals impacted by 9/11.
Schedule
- Fully remote
- Monday through Friday
- 8:30 AM – 5:00 PM EST
- Must be available to work 8 AM – 5 PM EST, depending on business needs
Responsibilities
Claims Review and Processing
- Analyze, review, and process complex medical claims following program policies.
- Adjudicate claims based on established guidelines and apply critical thinking to nuanced scenarios.
Timely Processing
- Ensure claims are completed within required timelines.
- Identify processing barriers and resolve them using effective problem-solving strategies.
Issue Resolution
- Collaborate with internal teams to resolve discrepancies.
- Investigate root causes of issues and implement appropriate solutions.
Confidentiality Maintenance
- Protect patient information and company data in compliance with HIPAA regulations.
Record Keeping
- Maintain complete, accurate documentation of processed, denied, or escalated claims.
Trend Monitoring
- Review and report trends in claim irregularities.
- Assist Team Leads with data reporting to improve processes.
Audit Participation
- Participate in audits, compliance checks, and internal reviews.
- Provide recommendations for improvements when needed.
Mentoring
- Support and mentor new claims processors as assigned.
Requirements
- High school diploma or equivalent
- Minimum of 5 years of medical claims processing experience
- Must include professional and facility claims
- Must include complex and high-dollar claims
- Billing experience does not count toward the 5 years
- Familiarity with ICD-10, CPT, and HCPCS coding
- Understanding of medical terminology and insurance procedures
- Experience with workers’ compensation claims is a plus
- Strong attention to detail and accuracy
- Ability to interpret and apply insurance policies and government regulations
- Excellent verbal and written communication skills
- Proficiency in Microsoft Word, Excel, and Outlook
- Ability to manage high-volume claims independently and collaboratively
- Experience with appeals and denial resolution
- Strong critical thinking and customer-service mindset
- Ability to adapt to evolving client requirements and program changes
- Reliable high-speed internet with the ability to connect via ethernet cable
Benefits
- 401(k) with employer match
- Health, dental, and vision insurance
- Life insurance
- Flexible Paid Time Off (PTO)
- Paid holidays
Happy Hunting,
~Two Chicks…