About Company
BroadPath is a leading global services provider specializing in comprehensive Business Process Outsourcing (BPO) solutions, particularly within the healthcare sector. We partner with some of the largest and most innovative healthcare organizations, helping them streamline operations, enhance customer experience, and achieve their strategic goals. At BroadPath, we pride ourselves on our agile approach, advanced technological capabilities, and a deeply committed workforce that often operates in a remote-first environment. Our culture emphasizes continuous learning, mutual support, and a collective drive to make a meaningful impact on the healthcare industry. Join a team where your contributions are valued, and your career growth is a priority.
Job Description
We are seeking a highly detail-oriented and dedicated Healthcare Claims Processor to join our dynamic team at BroadPath. This full-time position offers an immediate start for individuals passionate about contributing to the efficiency and accuracy of healthcare administration from a remote setting within Canada. As a Healthcare Claims Processor, you will play a crucial role in ensuring the accurate and timely adjudication of medical claims, contributing directly to the financial health of our clients and the satisfaction of their members/patients. Your day-to-day responsibilities will involve meticulous review, data entry, and processing of various types of healthcare claims, ensuring strict adherence to policy guidelines, regulatory requirements, and client-specific protocols. This role requires exceptional analytical skills, a keen eye for detail, and the ability to interpret complex medical documentation and billing codes. You will be instrumental in identifying and resolving discrepancies, communicating with internal teams, and maintaining precise records within our claims processing systems. We are looking for an individual who thrives in a fast-paced environment, possesses strong problem-solving abilities, and is committed to upholding the highest standards of accuracy and confidentiality. If you are ready to leverage your organizational skills and healthcare knowledge to make a tangible difference in a supportive and forward-thinking organization, we encourage you to apply.
Key Responsibilities
- Accurately review, verify, and process various types of healthcare claims (medical, dental, vision, pharmacy) in accordance with plan benefits, policies, and regulatory guidelines.
- Interpret medical terminology, CPT, ICD-10, and HCPCS codes to ensure proper claim adjudication.
- Identify and resolve discrepancies, inconsistencies, or errors in claims data, collaborating with internal teams or providers as necessary.
- Maintain strict confidentiality and adhere to HIPAA regulations and other data privacy standards.
- Document all claim processing activities and decisions clearly and concisely within the claims management system.
- Stay updated on changes in healthcare regulations, coding guidelines, and client-specific plan provisions.
- Participate in ongoing training and quality assurance initiatives to continuously improve claims processing accuracy and efficiency.
- Contribute to a positive and productive team environment, offering support and assistance to colleagues when needed.
Required Skills
- 1-2 years of experience in healthcare claims processing or a related administrative role.
- Strong understanding of medical terminology, CPT, ICD-10, and HCPCS coding.
- Exceptional attention to detail and accuracy.
- Proficiency in data entry and experience with claims processing software/systems.
- Excellent analytical and problem-solving skills.
- Strong verbal and written communication skills.
- Ability to work independently in a remote environment with minimal supervision.
- Proven ability to manage time effectively and meet deadlines.
Preferred Qualifications
- Post-secondary education in Medical Office Administration, Health Information Management, or a related field.
- Familiarity with various types of health insurance plans (e.g., PPO, HMO, EPO) and their benefit structures.
- Experience with specific claims adjudication platforms (e.g., Facets, Amisys, QNXT).
- Certification in medical coding (e.g., CPC, CCS) or billing.
- Bilingualism (English and French) is considered an asset.
Perks & Benefits
- Competitive salary and performance-based incentives.
- Comprehensive health, dental, and vision benefits package.
- Paid time off and holiday pay.
- Opportunities for professional development and career advancement.
- A supportive and collaborative remote work culture.
- Access to modern technology and robust training resources.
- Employee assistance program.
- Work-from-home flexibility, saving on commute time and costs.
How to Apply
Interested candidates are invited to apply by clicking on the application link below. Please ensure your resume highlights your relevant experience in healthcare claims processing and your commitment to accuracy and efficiency. We look forward to reviewing your application!