Medicaid Claims Processor

Broadpath Healthcare Solutions, Inc.; United States; Remote; USD 40,000 - 60,000; Full time

Job summary

Join a leading healthcare solutions company as a Medicaid Claims Processor in a remote role. This key position is responsible for ensuring the accurate and timely adjudication of Medicaid claims while adhering to CMS regulations. The ideal candidate will have experience in claims processing and proficiency in QNXT systems, playing a vital role in maintaining compliance and documentation accuracy.

Qualifications

• 1 year of experience in Medicaid claims processing.
• Strong attention to detail and analytical skills.
• Ability to work independently in a remote environment.

Responsibilities

• Accurately process Medicaid insurance claims.
• Review and adjudicate claims based on guidelines and regulations.
• Identify and resolve discrepancies within claims.

Skills

Attention to detail

Analytical skills

Organizational skills

Effective communication

Education

High school diploma or equivalent

Tools

QNXT systems

Job description

Overview

BroadPath is seeking aMedicaid Claims Processor to join our remote team. The ideal candidate will have strong experience in Medicaid claims processing and be proficient in using QNXT systems. This position is essential for ensuring accurate and timely adjudication of health insurance claims while maintaining compliance with policy guidelines and CMS regulations. The Medicaid Claims Processor will also resolve discrepancies, identify issues, and maintain accurate documentation to support the claims process.

Responsibilities

• Accurately process Medicaid insurance claims, ensuring all data is correctly entered and verified
• Review and adjudicate claims based on policy guidelines, regulations, and best practices
• Use the QNXT system to manage claims, perform data entry, and ensure records are updated in real time
• Adhere to all CMS guidelines and ensure regulatory compliance
• Identify, troubleshoot, and resolve discrepancies or issues within claims to ensure smooth processing
• Maintain detailed and accurate records, documentation, and reports to track claim status and outcomes
• Communicate effectively with internal teams and external partners to clarify claim-related questions or resolve issues
• Stay current on industry standards, policy updates, and changes in healthcare insurance regulations
• Assist in process improvement initiatives to enhance claims accuracy and efficiency
• Perform additional duties as assigned in support of the broader claims processing team

Qualifications

• 1 year of experience in Medicaid claims processing
• Proficiency in using QNXT systems for claims management and data entry
• Strong attention to detail and analytical skills, ensuring accuracy in claims adjudication and issue resolution
• Excellent organizational skills, with the ability to manage multiple claims and meet strict deadlines
• Effective verbal and written communication skills for collaborating with team members and external stakeholders
• Ability to work independently in a remote environment while maintaining high productivity and focus
• High school diploma or equivalent required

Diversity Statement

At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans

If you need accommodation due to a disability, please email us [e-mail]. This information will be held in confidence and used only to determine an appropriate accommodation for the application process

BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.

Compensation:BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.