**Overview** *Required On-site training in **Campbell, CA** (Beautiful Bay Area!) for a week. BroadPath is hiring a **Claims Research Examiner** to join our team. As a **Claims Research Examiner** , you'll play a crucial role in our organization, ensuring accurate adjudication of all claims for PPMSI contracted plans. This position offers a unique opportunity to leverage your analytical skills and healthcare knowledge to make a real difference in people's lives. **Responsibilities** + Expertly adjudicate recalculations and resolve system edits for both hardcopy and electronic claims + Lead the resolution of complex claims issues, identifying root causes and collaborating with cross-functional teams + Provide invaluable technical support and training to claims examiners, fostering a culture of continuous improvement + Navigate and interpret plan contracts, provider pricing, and benefit plans to ensure accurate claims processing + Engage in the Provider Dispute Resolution process, adhering to AB1455 guidelines **What You'll Bring** + A sharp analytical mind with a knack for problem-solving + Excellent communication skills and a collaborative spirit + Ability to thrive in a fast-paced, production-oriented environment + Keen attention to detail and a commitment to quality + Proficiency in claims processing software and Microsoft Office suite + Knowledge of medical terminology and healthcare industry standards (DMHC, CMS, NCQA) **Qualifications** + High school diploma or equivalent + 2+ years of claims processing experience, including at least one year as a claims examiner + Solid understanding of ICD-9, CPT, HCPC, and Revenue Coding Must be available for a minimum of 7 days of travel. On-Site Training: This role requires on-site training in Campbell, CA. **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.