Bring your attention to detail and problem-solving skills to a role where your work makes a meaningful impact. Broadway Ventures is hiring a Medical Claims Processor II to support the World Trade Center Health Program by accurately reviewing and processing complex medical claims.
About Broadway Ventures
Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) delivering expert program management, cutting-edge technology, and innovative consulting solutions. We empower government and private sector clients by turning challenges into opportunities through collaboration, integrity, and excellence.
Schedule
- Full-time, remote position
- Monday–Friday, 8:30 AM to 5:00 PM EST
- Must be able to work standard Eastern hours
What You’ll Do
- Analyze and process complex professional and facility medical claims in compliance with program guidelines
- Adjudicate claims using critical thinking to resolve high-dollar and complex scenarios
- Ensure timely claims processing while meeting client standards and regulations
- Collaborate with internal teams to resolve discrepancies and barriers
- Maintain accurate and confidential patient and claims records in compliance with HIPAA
- Monitor trends and support reporting to improve processes
- Participate in audits, compliance reviews, and recommend process improvements
- Mentor and train new claims processors as needed
What You Need
- High school diploma or equivalent (college preferred)
- 5+ years of medical claims processing experience (billing does not qualify)
- Experience with both professional and facility claims, including complex/high-dollar claims
- Familiarity with ICD-10, CPT, and HCPCS coding systems
- Knowledge of medical terminology, healthcare services, and insurance procedures (workers’ comp experience a plus)
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook)
- Strong problem-solving and communication skills
- Ability to manage high volumes efficiently and independently
- Experience with claim denial resolution and appeals processes
- Commitment to confidentiality, accuracy, and ongoing professional development
Benefits
- 401(k) with employer match
- Health, dental, and vision insurance
- Life insurance
- Flexible PTO and paid holidays
Take the next step in your career while supporting a program that matters to communities.
Happy Hunting,
~Two Chicks…