Work from home while playing a key role in how healthcare dollars are spent. If you are detail focused, comfortable with medical claims, and want a Monday through Friday remote job with steady hours, this Claims Examiner role lines up well.
About BroadPath
BroadPath partners with healthcare organizations to provide specialized, remote support in claims, member services, and operations. As a Claims Examiner, you help protect financial integrity by accurately processing medical claims, resolving issues, and supporting providers and members. BroadPath provides structure, tools, and a remote friendly culture so you can focus on accuracy and performance.
Schedule
- Fully remote role within the United States
- Training: 5 days, Monday through Friday, 8:00 a.m. to 5:00 p.m. PST
- Production: Monday through Friday, 8:00 a.m. to 5:00 p.m. PST
- No weekends
What You’ll Do
- Adjudicate a variety of claims, including both routine and complex cases, for hardcopy and electronic submissions
- Communicate with providers and members to resolve questions about claims, eligibility, and authorizations
- Generate emergency reports and authorizations for claims that are missing prior approval
- Process third party liability and coordination of benefits claims according to company policies
- Assist with reviewing stop loss reports and flag members approaching reinsurance thresholds
- Escalate potential system programming issues to supervisors when identified
- Provide guidance and informal training to less experienced claims processors
- Recognize and properly route carved out claims based on plan contracts
- Apply knowledge of contracts, pricing, eligibility, referrals, benefits, and capitation to process claims accurately
- Work with Accounting to ensure correct posting of claims to general ledger accounts
- Partner with Customer Service and Provider Services on large claim projects and adjustments
- Interpret benefits and plan details through the cut log system when needed
- Support senior examiners with complex claim adjustments and take on additional tasks assigned by management
What You Need
- High school diploma or equivalent
- One to three years of medical claims processing experience
- Medicare claims experience
- Knowledge of ICD 9, CPT, HCPC, and revenue coding
- Strong analytical and problem solving skills to troubleshoot claim issues
- Clear communication skills and a customer service mindset for working with providers and members
- Ability to stay focused and accurate in a high volume, production driven environment
- Proficiency with claims processing software and related technology
- Understanding of medical terminology, coding, and healthcare regulations
- Ability to learn and apply complex claims procedures and policies
- Team oriented mindset with willingness to support and train others
- Comfort working under defined performance standards for speed and quality
- Systems experience with QXNT
Benefits
- Competitive base pay at 17 dollars per hour
- Weekly pay schedule
- Fully remote work with a consistent Monday through Friday daytime schedule
- No weekend hours
- Opportunity to deepen your experience in medical claims and grow toward senior level roles
- Inclusive culture that values diverse backgrounds and perspectives
Claims roles that are fully remote, weekday only, and offer weekly pay tend to go quickly, so do not wait if this fits your experience.
If you are ready to turn your claims skills into a stable work from home career move, this one is worth pursuing.
Happy Hunting,
~Two Chicks…