MMU Representative

Vafb; Richmond (VA); Hybrid; USD 49,000 - 52,000; Full time

Benefits offered by this job

Paid training

401K

Paid Time Off

Medical and dental insurance on day of

Job summary

VA Farm Bureau is seeking a Med Pay Claims Processor to handle and investigate medical expense and med pay claims from our Richmond office. The role offers a hybrid schedule after a 6-month in-office training period, with support from a Claims Medical Manager.

You will evaluate reserves, negotiate losses, and coordinate Medicare reporting, while building relationships with doctors and professionals. A strong analytical skill set and excellent communication are essential.

Qualifications

• High School diploma or equivalent.
• Experience in investigation, evaluation, and reserving techniques.

Responsibilities

• Promptly and equitably handle and investigate medical expense and med pay claims.
• Evaluate, reserve, adjust and negotiate medical expense losses and claims.
• Update Medicare reporting information and respond to Medicare correspondence.
• Serve as a technical resource for other claim department personnel.
• Develop relationships with doctors, medical professionals, audit vendors, lawyers and court personnel.
• Assist the CCHU with phone call handling, loss reports, and inquiries.

Skills

Analytical skills

Communication skills

Time management

Organization

Attention to detail

Multitasking

Rapport building

Initiative

Dependable

Education

High School diploma

Tools

Online systems

Stand-alone computer systems

Job description

COMPENSATION RANGE: $49,000-$52,000 Annually

LOCATION: Based out of our beautiful West Creek Office, located at 12580 West Creek Pkwy, Richmond, VA 23238. Hybrid schedule is offered, after in office 6-month training period is completed.

REPORTS TO: Claims Medical Manager

POSITION SUMMARY:

Process and investigate Med Pay claims in an efficient manner according to company policy.

PRIMARY DUTIES

• Promptly and equitably handle and investigate medical expense and medical pay claims
• Responsible for the evaluation, reserving, adjustment and negotiation of all assigned medical expense and med pay losses and claims.
• Responsible for updating all information for Medicare reporting and responding promptly and thoroughly to all correspondence from Medicare.
• Serve as a technical resource for other claim department personnel.
• Develop and maintain professional relationship with various doctors, medical professionals, audit vendors, lawyers and court personnel.
• Assist the CCHU with phone call handling, to include taking loss reports and answering general claims inquiry calls.
• Assist claims staff and other departments as needed

ADDITIONAL DUTIES

• Answer phones and back-up all other representatives
• All other duties as assigned by the supervisor

MINIMUM EDUCATIONAL/EXPERIENCE QUALIFICATIONS

• High School diploma or equivalent
• Previous experience in investigation, evaluation, and reserving techniques

MINIMUM SKILL QUALIFICATIONS

• Previous experience with online and stand-alone computer systems
• Dependable
• Proven analytical skills
• Excellent verbal and written communication skills
• High level of initiative/motivation
• Strong organizational skills
• Excellent attention to detail and time management
• Able to multi-task, prioritize and organize with limited supervision
• Able to build rapport quickly

PREFERRED QUALIFICATIONS

• INS Insurance courses
• AIC Insurance courses

At VA Farm Bureau, we provide an exceptional benefits package, including ongoing job development and support in all roles, paid training and continuing education reimbursement, medical and dental insurance available on your first day, generous employee 401K contribution, excellent Paid Time off (PTO) plan and more!

Virginia Farm Bureau Companies provide equal employment opportunity in all aspects of employment without regard to race, color, national origin, religion, gender, pregnancy, age, disability, orientation or veteran status.