Remote Medical Claims Processor

View Moreicons; United States; Remote; USD 19,000 - 28,000; Full time

Benefits offered by this job

Medical, Dental, Vision coverage

Life Insurance

Short-Term & Long-Term Disability

FSA

Employee Assistance Program

401(k) with employer contribution

PTO

Tuition Reimbursement

Job summary

BroadPath, a Sagility Company, is hiring experienced medical Claims Processors to join our remote team. This role involves accurate, timely entry, review, and resolution of medical claims, with emphasis on CMS guidelines and client policies.

We offer weekly pay and a starting base rate of $17 per hour. Responsibilities include reviewing claims, researching across systems, applying benefits, and deciding on denial letters when needed.

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 claim forms.
• Working knowledge of ICD-10, HCPCS, and CPT coding systems.
• Proficient in Windows, Excel (advanced), and web-based tools; excellent verbal and written communication.

Responsibilities

• Review medical claims thoroughly to ensure no missing or incomplete information.
• Navigate multiple systems to research and process claims accurately (pricing, prior authorizations).
• Apply benefits per policy in line with CMS guidelines and client policies.
• Assess whether the visit was necessary and if the policy covers the treatment.
• Determine pay or denial and issue denial letters when applicable.

Skills

Claims processing

Communication

Focus in fast-paced work

Computer navigation

Education

High School Diploma or equivalent

Tools

Windows

Excel (advanced)

Web-based tools

Job description

BroadPath, a Sagility Company, is hiring experienced medical Claims Processors to join our remote team. This role involves accurate, timely entry, review, and resolution of medical claims, with emphasis on CMS guidelines and client policies.

We offer weekly pay and a starting base rate of $17 per hour. Responsibilities include reviewing claims, researching across systems, applying benefits, and deciding on denial letters when needed.