Use your expertise in complex medical claims to support a high-impact national program while working fully remote. This role is built for detail-oriented professionals who want stability, purpose, and meaningful contribution to community health.
About Broadway Ventures
Broadway Ventures is a trusted partner to government and private sector clients, delivering program management, innovative technology solutions, and expert consulting. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business, the company focuses on integrity, collaboration, and operational excellence. Their teams help organizations navigate complex challenges with tailored solutions that drive measurable success.
Schedule
Remote (United States)
Monday through Friday
8:30 AM to 5:00 PM EST
Must be available to work 8:00 AM to 5:00 PM EST
What You’ll Do
Analyze and process complex medical claims in alignment with program policies and compliance standards
Adjudicate claims using critical thinking to interpret program guidelines and resolve unique issues
Ensure timely processing to meet regulatory and client expectations
Collaborate with internal teams to resolve discrepancies efficiently
Maintain strict confidentiality of patient and company information per HIPAA
Document processed, denied, or investigatory claims with precision
Monitor trends in claim issues and provide reporting support to Team Leads
Participate in audits and evaluate processes for improvement opportunities
Mentor and train new claims processors as needed
What You Need
High school diploma or equivalent
Minimum 5 years of medical claims processing experience (not billing), including professional, facility, complex, and high-dollar claims
Familiarity with ICD-10, CPT, and HCPCS
Knowledge of medical terminology, insurance procedures, and healthcare services; workers’ compensation experience is a plus
Strong attention to detail and accuracy
Ability to interpret program policies and government regulations
Excellent written and verbal communication skills
Proficiency with Microsoft Office (Word, Excel, Outlook)
Ability to work independently and as part of a team
Experience with denial resolution and appeals
Ability to manage a high volume of work efficiently
Commitment to continuous learning and adapting to program changes
Customer service–oriented approach
Reliable high-speed internet with ethernet capability
Benefits
401(k) with employer match
Health, dental, and vision insurance
Life insurance
Flexible Paid Time Off
Paid holidays
Perfect for seasoned medical claims processors seeking a stable remote role where accuracy and expertise directly support community wellness.
Happy Hunting,
~Two Chicks…