Remote Medical Claims Processor I (Temporary role)

About this role

<div class="content-intro"><div class="et_pb_module et_pb_text et_pb_text_0 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"> <p style="text-align: justify;">At <strong>Broadway Ventures</strong>, 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.</p> </div> </div></div><p>This role is Temp thru November with a chance for follow-on work. </p> <p class="" data-start="272" data-end="617">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.</p> <p class="" data-start="619" data-end="638"><strong data-start="619" data-end="636">Work Schedule</strong></p> <ul> <li data-start="641" data-end="707">Remote</li> <li data-start="710" data-end="751">Monday through Friday, 8:30 AM to 5:00 PM EST</li> <li data-start="710" data-end="751">Must be able to work 8am - 5pm Eastern Standard Time</li> </ul> <h2 class="" data-start="753" data-end="772">Responsibilities</h2> <p class="" data-start="774" data-end="808"><strong data-start="774" data-end="806">Claims Review and Processing</strong></p> <ul data-start="809" data-end="952"> <li class="" data-start="809" data-end="952"> <p class="" data-start="811" data-end="952">Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.</p> </li> </ul> <p class="" data-start="954" data-end="977"><strong data-start="954" data-end="975">Critical Analysis</strong></p> <ul data-start="978" data-end="1095"> <li class="" data-start="978" data-end="1095"> <p class="" data-start="980" data-end="1095">Adjudicate claims according to program guidelines, applying critical thinking skills to navigate complex scenarios.</p> </li> </ul> <p class="" data-start="1097" data-end="1120"><strong data-start="1097" data-end="1118">Timely Processing</strong></p> <ul> <li data-start="1123" data-end="1210">Ensure prompt claims processing to meet client standards and regulatory requirements.</li> <li data-start="1213" data-end="1290">Identify and resolve any barriers using effective problem-solving strategies.</li> </ul> <p class="" data-start="1292" data-end="1314"><strong data-start="1292" data-end="1312">Issue Resolution</strong></p> <ul> <li data-start="1317" data-end="1405">Collaborate with internal departments to proactively resolve discrepancies and issues.</li> <li data-start="1408" data-end="1478">Use analytical skills to identify root causes and implement solutions.</li> </ul> <p class="" data-start="1480" data-end="1513"><strong data-start="1480" data-end="1511">Confidentiality Maintenance</strong></p> <ul data-start="1514" data-end="1619"> <li class="" data-start="1514" data-end="1619"> <p class="" data-start="1516" data-end="1619">Uphold confidentiality of patient records and company information in accordance with HIPAA regulations.</p> </li> </ul> <p class="" data-start="1621" data-end="1650"><strong data-start="1621" data-end="1648">Detailed Record Keeping</strong></p> <ul data-start="1651" data-end="1756"> <li class="" data-start="1651" data-end="1756"> <p class="" data-start="1653" data-end="1756">Maintain thorough and accurate records of claims processed, denied, or requiring further investigation.</p> </li> </ul> <p class="" data-start="1758" data-end="1780"><strong data-start="1758" data-end="1778">Trend Monitoring</strong></p> <ul> <li data-start="1783" data-end="1859">Analyze and report trends in claim issues or irregularities to management.</li> <li data-start="1862" data-end="1944">Assist Team Leads with reporting to contribute to continuous process improvements.</li> </ul> <p class="" data-start="1946" data-end="1971"><strong…