Talent.com
Medical Claims Processor I
Medical Claims Processor IBroadway Ventures • Atlanta, GA, US
Medical Claims Processor I

Medical Claims Processor I

Broadway Ventures • Atlanta, GA, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Job Description

Job Description

At Broadway Ventures , we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider—we're your trusted partner in innovation.

Become an integral part of a dedicated team supporting the World Trade Center Health Program. In this role, you will leverage your strong attention to detail and commitment to accuracy in processing complex medical claims. If you are eager to make a positive impact in the community through your administrative skills, we encourage you to apply.

Work Schedule

  • Remote
  • Monday through Friday, 8 : 30 AM to 5 : 00 PM EST
  • Must be able to work 8am - 5pm Eastern Standard Time

Responsibilities

Claims Review and Processing

Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.

Critical Analysis

Adjudicate claims according to program guidelines, applying critical thinking skills to navigate complex scenarios.

Timely Processing

  • Ensure prompt claims processing to meet client standards and regulatory requirements.
  • Identify and resolve any barriers using effective problem-solving strategies.
  • Issue Resolution

  • Collaborate with internal departments to proactively resolve discrepancies and issues.
  • Use analytical skills to identify root causes and implement solutions.
  • Confidentiality Maintenance

    Uphold confidentiality of patient records and company information in accordance with HIPAA regulations.

    Detailed Record Keeping

    Maintain thorough and accurate records of claims processed, denied, or requiring further investigation.

    Trend Monitoring

  • Analyze and report trends in claim issues or irregularities to management.
  • Assist Team Leads with reporting to contribute to continuous process improvements.
  • Audit Participation

  • Engage in audits and compliance reviews to ensure adherence to internal and external regulations.
  • Critically evaluate and recommend process improvements when necessary.
  • Mentoring

  • Mentor and train new claims processors as needed.
  • Requirements

  • High school diploma or equivalent.
  • Minimum of five years of experience in medical claims processing, including professional and facility claims, as well as complex and high-dollar claims.
  • Billing experience doesn't count towards years of experience qualification

  • Familiarity with ICD-10, CPT, and HCPCS coding systems.
  • Understanding of medical terminology, healthcare services, and insurance procedures (experience with worker's compensation claims is a plus).
  • Strong attention to detail and accuracy.
  • Ability to interpret and apply insurance program policies and government regulations effectively.
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
  • Ability to work independently and collaboratively within a team environment.
  • Commitment to ongoing education and staying current with industry standards and technology advancements.
  • Experience with claim denial resolution and the appeals process.
  • Ability to manage a high volume of claims efficiently.
  • Strong problem-solving capabilities and a customer service-oriented mindset.
  • Flexibility to adjust to the evolving needs of the client and program changes.
  • Benefits

  • 401(k) with employer matching
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life insurance
  • Flexible Paid Time Off (PTO)
  • Paid Holidays
  • What to Expect Next :

    After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting.

    Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.

    [job_alerts.create_a_job]

    Medical Processor • Atlanta, GA, US

    [internal_linking.similar_jobs]
    Experienced Claims Processor

    Experienced Claims Processor

    VirtualVocations • Alpharetta, Georgia, United States
    [job_card.full_time]
    A company is looking for an Experienced Claims Processor to join their rapidly growing team.Key Responsibilities Review and adjudicate medical claims, ensuring accurate coding and data entry Ver...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Nuclear Medicine Tech - $2,311 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,311 per week in Fayetteville, GA

    Triage Staffing LLC • Fayetteville, GA, US
    [job_card.full_time]
    Travel Radiology : Nuclear Medicine Tech Fayetteville.Location : Fayetteville.Shift Details : 8H Days (8 : 00 AM-4 : 30 PM). Length : 16 WEEKS 16 weeks.Apply for specific facility details.[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Nuclear Medicine Tech - $2,377 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,377 per week in Fayetteville, GA

    Atlas MedStaff • Fayetteville, GA, US
    [job_card.full_time]
    Atlas Medstaff is currently seeking candidates in the Nuclear Tech (Nuclear Tech) profession for a 16 week contract in the Fayetteville, Georgia area. Atlas Medstaff is a premier staffing firm dedic...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    CRNA - Anesthesiology job available in Griffin, Georgia

    CRNA - Anesthesiology job available in Griffin, Georgia

    United Digestive • Griffin, GA, US
    [job_card.full_time]
    We are looking for CRNAs who enjoy working in a team-oriented and fast-paced environment.GI endoscopy experience is preferred. CRNA’s main responsibilities are evaluating patients prior to the...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel Nuclear Medicine Tech - $2,202 to $2,402 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,202 to $2,402 per week in Fayetteville, GA

    Titan Medical Group • Fayetteville, GA, US
    [job_card.full_time]
    Travel - Nuclear Medicine Tech.Fayetteville, GA, United States.NMTCB / ARRT(N) / BCLS / BLS - American Heart Association. Nuc Med Tech (Travel, PET Focus) - Fayetteville, GA.Shift Day 5x8-Hour (08 : 00 - 16...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Nuclear Medicine Tech - $2,082 to $2,393 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,082 to $2,393 per week in Fayetteville, GA

    AlliedTravelNetwork • Fayetteville, GA, US
    [job_card.full_time]
    AlliedTravelNetwork is working with Fusion Medical Staffing to find a qualified Nuclear Medicine Tech in Fayetteville, Georgia, 30214!. Facility in Fayetteville, Georgia.Fusion Medical Staffing is s...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Nuclear Medicine Tech - $2,202 to $2,402 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,202 to $2,402 per week in Fayetteville, GA

    AlliedTravelNetwork • Fayetteville, GA, US
    [job_card.full_time]
    AlliedTravelNetwork is working with Titan Medical Group to find a qualified Nuclear Medicine Tech in Fayetteville, Georgia, 30214!. Travel - Nuclear Medicine Tech.Fayetteville, GA, United States.NMT...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Physician (MD / DO) - Internal Medicine - General / Other in Fayetteville, GA

    Physician (MD / DO) - Internal Medicine - General / Other in Fayetteville, GA

    LocumJobsOnline • Fayetteville, GA, US
    [job_card.full_time]
    Doctor of Medicine | Internal Medicine - General / Other.Competitive weekly pay (inquire for details) .LocumJobsOnline is working with CompHealth to find a qualified Internal Medicine MD in Fayettevi...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel CT Tech - $2,334 per week in Fayetteville, GA

    Travel CT Tech - $2,334 per week in Fayetteville, GA

    AlliedTravelCareers • Fayetteville, GA, US
    [job_card.full_time]
    AlliedTravelCareers is working with OneStaff Medical to find a qualified CT Tech in Fayetteville, Georgia, 30214!.An independently-owned, nationally-recognized and amazingly awesome staffing firm r...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel Nuclear Medicine Tech - $2,369 to $2,569 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,369 to $2,569 per week in Fayetteville, GA

    AlliedTravelCareers • Fayetteville, GA, US
    [job_card.full_time]
    AlliedTravelCareers is working with Ventura MedStaff to find a qualified Nuclear Medicine Tech in Fayetteville, Georgia, 30214!. Are you ready to take your Travel career to the next level? See plac...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Locum Physician (MD / DO) - Infectious Disease in Roswell, GA

    Locum Physician (MD / DO) - Infectious Disease in Roswell, GA

    LocumJobsNetwork • Roswell, GA, US
    [job_card.full_time] +1
    LocumJobsNetwork is working with CompHealth to find a qualified Infectious Disease MD in Roswell, Georgia, 30076!.CompHealth services are always free to you. Let us do the heavy lifting and handle t...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel Nuclear Medicine Tech - $2,082 to $2,393 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,082 to $2,393 per week in Fayetteville, GA

    Fusion Medical Staffing • Fayetteville, GA, US
    [job_card.full_time]
    Facility in Fayetteville, Georgia.Fusion Medical Staffing is seeking a skilled Nuclear Medicine Tech for a 16-week travel assignment in Fayetteville, Georgia. As a member of our team, you'll have th...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Locum Physician (MD / DO) - Infectious Disease in Roswell, GA

    Locum Physician (MD / DO) - Infectious Disease in Roswell, GA

    LocumJobsOnline • Roswell, GA, US
    [job_card.full_time]
    Doctor of Medicine | Infectious Disease.Competitive weekly pay (inquire for details) .LocumJobsOnline is working with CompHealth to find a qualified Infectious Disease MD in Roswell, Georgia, 30076...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Telemedicine Physician

    Telemedicine Physician

    QuickMD • Hampton, GA, US
    [job_card.full_time]
    QuickMD is a leading telemedicine provider, delivering high-quality virtual care across 44 states.Since our founding in 2019, we have helped more than 100,000 patients access essential medical trea...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Healthcare Claims Processor

    Healthcare Claims Processor

    VirtualVocations • Alpharetta, Georgia, United States
    [job_card.full_time]
    A company is looking for a Healthcare Claims Processor to support a leading health insurance customer.Key Responsibilities Review and adjudicate complex medical claims, both paper and electronic ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    CRNA - Anesthesiology job available in Fayetteville, Georgia

    CRNA - Anesthesiology job available in Fayetteville, Georgia

    Jackson and Coker • Fayetteville, GA, US
    [job_card.full_time]
    Three, 12 hours shifts Monday-Friday (more available if desired) .Looking for candidates to work Monday and Fridays, 1 Friday off per month max. In house call available (not required) .Cas...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel Nuclear Medicine Tech - $2,729 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,729 per week in Fayetteville, GA

    Care Career • Fayetteville, GA, US
    [job_card.full_time]
    Nuclear medicine technologists prepare radioactive drugs and administer them to patients for imaging or treatment.They provide technical support to physicians or others who diagnose, care for, and ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Nuclear Medicine Tech - $2,084 to $2,310 per week in Fayetteville, GA

    Travel Nuclear Medicine Tech - $2,084 to $2,310 per week in Fayetteville, GA

    LRS Healthcare • Fayetteville, GA, US
    [job_card.full_time]
    Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24 / 7 support, and a responsive, traveler-first culture. What are you waiting for? Apply today!.Valid license...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]