Remote Medical Claims Processor

Sagility Member Enrollment LLC; United States; Remote; USD 19,000 - 28,000; Full time

Benefits offered by this job

Medical, Dental, and Vision

401(k) with employer contribution

PTO

Tuition Reimbursement

Life Insurance

Disability (Short/Long)

FSA

EAP

Paid Time Off

Background checks

Job summary

BroadPath, a Sagility Company, is hiring experienced medical Claims Processors to join our remote team. You will review and process medical claims from start to finish, ensuring accuracy and compliance with CMS guidelines.

Claims will be reviewed across multiple platforms, with pay and schedule details determined by client needs. We offer a remote, work-from-home role with weekly pay and benefits including medical, dental, vision, life insurance, disability, FSA, 401(k), PTO, and tuition

Qualifications

• Minimum of one year of recent experience processing medical claims for a health insurance company or payer.
• Familiarity with CMS-1500 and UB-04 forms.
• Working knowledge of ICD-10, HCPCS, and CPT coding systems.
• Proficient with Windows OS and Excel.
• Excellent verbal and written communication skills.
• Ability to stay focused in a high-volume, repetitive environment.

Responsibilities

• Review medical claims thoroughly to ensure information is complete.
• Navigate systems to research and process claims accurately.
• Apply benefits per policy, including CMS guidelines and state mandates.
• Assess whether a visit is necessary and covered.
• Determine pay/deny outcomes and issue denial letters when applicable.

Skills

Medical claims processing

CMS-1500 & UB-04 familiarity

ICD-10, HCPCS, CPT knowledge

Microsoft Windows

Excel (advanced)

Strong communication

High-volume/repetitive work

High School Diploma or equivalent

Education

High School Diploma or equivalent

Tools

Microsoft Windows

Excel

Job description

BroadPath, a Sagility Company, is hiring experienced medical Claims Processors to join our remote team. You will review and process medical claims from start to finish, ensuring accuracy and compliance with CMS guidelines.

Claims will be reviewed across multiple platforms, with pay and schedule details determined by client needs. We offer a remote, work-from-home role with weekly pay and benefits including medical, dental, vision, life insurance, disability, FSA, 401(k), PTO, and tuition