Role Description To evaluate auto claims involving injured parties and manage first party medical treatment to determine eligibility under a personal injury protection and/or medical payment benefits. - Reviews claims to determine the nature of the medical loss and provides explanation of coverage. - Researches policy contract and interprets policy language to make coverage decisions based on 1st party medical coverage. - Assesses medical treatment, evaluates medical bills, and initiates or reviews potential fraud investigations. - Interprets medical records regarding injuries and addresses ongoing and continuous treatment for claimant. - Identifies claim exposures and establishes reserves or adjusts reserves accordingly on assigned files. - Ensures claim files are properly documented and correctly coded based on the policy. - Documents all claim activity and workflow accurately throughout the life of the claim in accordance with standard operating procedures. - Provides effective and timely communication to client, claimants, medical providers, attorney offices, and vendors. - Negotiates resolution of claims and makes payments within authority. - Performs other duties as assigned. Qualifications - Bachelor's degree from an accredited college or university preferred. - State adjuster licenses required. - Three (3) years of Personal Injury Protection (PIP), medical payment and/or workers compensation or equivalent combination of education and experience; nursing experience a plus. - Knowledge of medical terminology and appropriate application of deductibles and limits. - Familiarity with Bodily Injury (BI)/Casualty adjusting. - Oral and written communication skills. - PC literate, including Microsoft Office products. - Organizational skills required. Requirements - Physical: Computer keyboarding. - Auditory/visual: Hearing, vision and talking. - Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines. Benefits - Medical, dental, vision. - 401k and matching. - PTO. - Disability and life insurance. - Employee assistance. - Flexible spending or health savings account. - Other additional voluntary benefits.

Role Description The Claims Specialist resolves medical claims that are not automatically adjudicated by the claims processing system in a timely and accurate manner according to divisional standards of quality and productivity. Resolution may include additional investigation or communication in order to obtain necessary information to complete the claim. Outside issues such as peak filing season, systems down time, inclement weather, holidays, and absenteeism may directly affect the volume of work for each Specialist. Qualifications - High School diploma or equivalent. - Minimum two (2) years' college coursework (48 semester hours) or other equivalent certification with an emphasis in anatomy, medical terminology, math, biology, or a related field. - OR minimum one (1) year of related office experience such as claims processing, health insurance, or medical office. - Must pass company proficiency test: Claims Assessment. Requirements - Oral & Written Communications - Strong Interpersonal skills - Sound Judgement - Decision Making - Detail-Oriented - Teamwork - Dependability - Clinical Judgment - Computer Work - Critical Thinking - Customer Service - Evaluating Information - Interpersonal Communication - Oral Communications - Organizing - Process Information - Reading Comprehension - Researching - Time Management Responsibilities - Claims Processing: Involves the actions required to pay or deny pended claims (those which did not auto-adjudicate), including: - Entering data into the system - Reviewing and interpreting contract benefits - Conducting edit and audit resolution - Determining benefit eligibility - Identifying and researching processing issues through systems and manuals - Routing claims to other areas - Consulting internal staff and medical providers - Generating correspondence - Completing forms to obtain necessary information - Knowledge/Continuous Learning: Must undergo initial training, on-the-job training, and continuing education. Responsibilities include: - Demonstrating knowledge of and possessing the ability to access all relevant computer systems and screens to process claims accurately - Staying current with continually changing processing procedures, benefits, and system modifications - Meeting corporate and national (MTM) standards while maintaining acceptable performance levels based on established departmental standards for productivity and quality - Familiarity with corporate and professional manuals and guidebooks, including the company processing manual and ICD, CPT, and HCPS codebooks - Other duties: As assigned Certifications This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual. Segregation of Duties Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual. Employment Type Regular ADA Requirements 1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.

Role Description Enterprise Mobility is looking for remote employees who live in the state of Oklahoma to join our Phone Representative team! When damage occurs to our company property - primarily our rental vehicles - the Damage Recovery Unit works to recover costs for those damages. Phone Representatives are responsible for: - Receiving incoming calls from renters, third parties, credit card companies, and insurance companies - Directing the call to the appropriate person or taking the necessary information - Handling claim files with specialized functions - Providing professional customer service that reflects positively on the company - Successfully managing conflict during difficult or emotional situations - Effectively communicating with individuals related to a claim file - Completing outbound calls to report claims to insurance carriers - Adhering to company policies, procedures, guidelines, and state and federal laws - Performing other miscellaneous job-related duties as assigned Qualifications - Must currently live in the state of Oklahoma - At least one year of continuous employment with the same company - Willing to accept $15.09/hr for this position - Previous call center experience preferred - Customer service experience via phone or e-mail communication preferred - At least basic/beginner skill level in Microsoft Office products (Outlook, Word, and Excel) is required - Permanent residence with a defined work space that is free of distractions - Consistent and reliable high-speed internet access - Available to attend the full first week of training, Monday-Friday from 7:00 AM to 4:00 PM CST - Able to work full-time schedule, Monday-Friday from 9:00 AM to 5:30 PM CST - Authorized to work in the United States without requiring work authorization sponsorship - At least 18 years old Requirements - Training will take place the first week of employment, Monday through Friday from 7:00 am CST to 4:00 pm CST - Regular schedule is full-time 9:00 am CST to 5:30 pm CST, Monday through Friday Benefits - Compensation package of $15.09 / hour - Paid virtual training - Full-time benefits including medical, dental & vision - 401k with a company match of up to 4% and profit sharing - Paid time off - Employee discounts - Much more! Company Description We Work Hard and Reward Hard Work!

• Receives and processes claims including entering/verifying claims data • Resolves claim edits and determines benefit eligibility • Reviews payment levels and elevates issues to supervision as necessary • Meets production and quality standards, ensuring timely and accurate work • Maintains accurate records including timekeeping • Attends all required training classes