**Overview** BroadPath is seeking a **Healthcare Commercial Claims Processor** to join our remote team. The ideal candidate will have strong experience in Commercial/ACA claims processing and be proficient in using QNXT systems. This position is essential for ensuring accurate and timely adjudication of commercial insurance claims while maintaining compliance with policy guidelines and CMS regulations. The Healthcare Commercial Claims Processor will also resolve discrepancies, identify issues, and maintain accurate documentation to support the claims process. **Responsibilities** + Accurately process Commercial/ACA Healthcare claims, ensuring all data is correctly entered and verified + Review and adjudicate claims based on policy guidelines, regulations, and best practices + Use the QNXT system to manage claims, perform data entry, and ensure records are updated in real time + Handle Commercial/ACA Healthcare processing while adhering to all CMS guidelines and ensuring regulatory compliance + Identify, troubleshoot, and resolve discrepancies or issues within claims to ensure smooth processing + Maintain detailed and accurate records, documentation, and reports to track claim status and outcomes + Communicate effectively with internal teams and external partners to clarify claim-related questions or resolve issues + Stay current on industry standards, policy updates, and changes in Medicare and commercial insurance regulations + Assist in process improvement initiatives to enhance claims accuracy and efficiency + Perform additional duties as assigned in support of the broader claims processing team **Qualifications** + 1 year of experience in Commercial/ACA Healthcare claims processing, with an understanding of CMS guidelines and procedures + Proficiency in using QNXT systems for claims management and data entry + Strong attention to detail and analytical skills, ensuring accuracy in claims adjudication and issue resolution + Excellent organizational skills, with the ability to manage multiple claims and meet strict deadlines + Effective verbal and written communication skills for collaborating with team members and external stakeholders + Familiarity with commercial insurance policies and claims guidelines is preferred + Ability to work independently in a remote environment while maintaining high productivity and focus + High school diploma or equivalent required **Diversity Statement** At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation! Equal Employment Opportunity/Disability/Veterans If you need accommodation due to a disability, please email us at HR@Broad-path.com . This information will be held in confidence and used only to determine an appropriate accommodation for the application process BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.