Join a mission-driven team supporting the World Trade Center Health Program. At Broadway Ventures, we turn challenges into opportunities with innovative consulting solutions and expert program management. This role is perfect for an experienced medical claims processor who thrives in high-volume, detail-driven environments and wants to make a meaningful impact.
About Broadway Ventures
Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) providing tailored solutions that drive operational success, sustainability, and growth for government and private sector clients. Built on integrity, collaboration, and excellence, we are more than a service provider—we’re your trusted partner in innovation.
Schedule
- Full-time, remote
- Monday–Friday, 8:30 AM – 5:00 PM EST
- Must be able to work Eastern hours
Responsibilities
- Analyze and process complex medical claims in compliance with program policies.
- Apply critical thinking skills to adjudicate claims according to guidelines.
- Ensure timely claims processing to meet regulatory and client standards.
- Identify, investigate, and resolve discrepancies and claim issues.
- Uphold confidentiality of patient information under HIPAA regulations.
- Maintain accurate records of claims processed, denied, or flagged for review.
- Monitor and report claim trends to management for process improvement.
- Participate in audits and compliance reviews; recommend improvements.
- Mentor and train new claims processors as needed.
Requirements
- High school diploma or equivalent.
- 5+ years of experience in medical claims processing (professional and facility claims, including complex/high-dollar). Billing experience does not count toward this requirement.
- Familiarity with ICD-10, CPT, and HCPCS coding.
- Knowledge of medical terminology, healthcare services, and insurance procedures (workers’ compensation a plus).
- Experience with claim denial resolution and appeals.
- Proficiency with Microsoft Office Suite (Word, Excel, Outlook).
- Strong attention to detail, accuracy, and problem-solving skills.
- Excellent written and verbal communication.
- Ability to work independently and in a collaborative team environment.
- Commitment to staying current with industry standards and regulations.
- High-volume claims management experience.
Benefits
- 401(k) with employer match
- Health, dental, vision, and life insurance
- Flexible Paid Time Off (PTO)
- Paid holidays
Be part of a team that values integrity, excellence, and service while supporting a program that makes a difference in people’s lives.
Happy Hunting,
~Two Chicks…