**Overview** Join our innovative healthcare team as a **Claims Processor** , working from the comfort of your home while making a meaningful impact on our members' lives. We're seeking an experienced professional to help advance our member-centric approach to healthcare through expert claims review and adjudication using our state-of-the-art claims system. As a **Claims Processor** , you'll play a crucial role in ensuring our members receive accurate and timely claim processing while working remotely. **Responsibilities** + Process medical claims with precision by evaluating coverage, calculating benefits, and ensuring compliance with national guidelines and company policies + Manage claim-specific calculations including deductibles, out-of-pocket maximums, and accumulators to ensure accurate benefit administration + Collaborate virtually with our Quality team to resolve complex claims and contribute to process improvements + Maintain high productivity standards while meeting quality metrics and departmental goals + Document and communicate complex claims issues effectively with stakeholders across digital platforms + Participate in developing and refining Standard Operating Procedures (SOPs) to enhance departmental efficiency **Qualifications** + High School Diploma + Minimum 1 year of medical claims processing experience + Proven experience with ICD-10 coding + Strong critical thinking and analytical skills + Proficiency in virtual collaboration tools (Zoom and Microsoft Teams) + Demonstrated knowledge of CMS claims submission regulations + Excellent time management skills with ability to work independently + Strong computer literacy and ability to navigate multiple applications + Must speak English fluently + Must reside in Metro Manila **Preferred Qualifications** + Medical Coding certification + Experience with Javelina claims processing system + Medical billing background + In-depth understanding of provider data and CPT/HCPC code rules **Why Choose Us?** + Flexible work-from-home environment + Comprehensive training and professional development + Collaborative team culture + Cutting-edge claims processing technology + Opportunity to contribute to healthcare innovation + Competitive benefits package **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. Compensation: BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.