Medical Claims Processor II
a day ago
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RemoteFull-timeSenior
Summary
Broadway Ventures, LLC is seeking a Medical Claims Processor II to join their team in Atlanta, GA. The role involves processing complex medical claims with a strong attention to detail and commitment to accuracy.
About the Role
As a Medical Claims Processor II, you will analyze and process a variety of complex medical claims, adjudicate claims according to program guidelines, ensure timely processing, resolve discrepancies, maintain confidentiality, keep detailed records, monitor trends, participate in audits, and mentor new claims processors.
About You
Required:
- 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.
- Familiarity with ICD-10, CPT, and HCPCS coding systems.
- Strong attention to detail and accuracy.
- Excellent written and verbal communication skills.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
- Ability to work independently and collaboratively within a team environment.
Preferred:
- Understanding of medical terminology, healthcare services, and insurance procedures.
- Experience with claim denial resolution and the appeals process.
- 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
BROADWAY VENTURES, LLC
We deliver expert program management, cutting-edge IT, cybersecurity, and consulting solutions for government and commercial clients. Our mission is to drive efficiency and sustainable value, empowering underserved communities and ensuring a lasting impact across sectors such as defense, healthcare, and environmental sustainability. We are an 8(a) certified, HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) dedicated to excellence and innovation.
Atlanta, GA