• Analyze workers compensation claims on behalf of our valued clients to determine benefits due. • Ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. • Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. • Negotiating settlement of claims within designated authority. • Communicating claim activity and processing with the claimant and the client. • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Role Description A Claims Invoice Processor is responsible for receiving, verifying and issuing payments to repair facilities, vendors and contract holders. This position also includes answering internal and external phone inquiries and providing information and explanations on the various levels of contract coverage and terms. - Review invoices for accuracy and issue payment to repair facilities nationwide - Analyze information in contracts and claim system to apply appropriate benefit amounts - Distribute internal information to aid Claims Adjudication Department - Answer phone inquiries and provide information and explanations on the various levels of contract coverage and terms - Manage workflow, process and complete all payment requests and documents according to established procedures - Be a team member, work effectively in a friendly team environment - Being interactive and communicative with management and co-workers in a visible manner is an essential function of the job; therefore, camera usage is required for training, team meetings, and meetings with management. - Other Job Duties, as assigned Qualifications - Minimum High School graduate or GED is Required - Strong organizational and customer service skills with ability to problem solve and multitask - Must be detail oriented with a high level of accuracy in data entry skills - The ability to maintain confidentiality of sensitive information - Possess excellent written and verbal communication skills - Must be able to communicate effectively with contract holders, agents, dealers, internal staff/upper management and customers - Call center experience preferred - Proficient working on a PC, working knowledge of MS Office - Able to learn new programs quickly - Type at least 40 wpm, and document information while discussing the claim over the phone - The candidate(s) offered this position would be required to submit to a background investigation Requirements - Compensation: $18.00/hour Benefits - Competitive salary - 401(k) with company match after 90-days of employment - Medical, Dental and Vision Insurance - Voluntary Life Insurance - Internet Stipend - A company culture that supports balancing your work and personal life, including company events, bonding experiences and a work from home environment

Role Description Process all MVH overseas claims from receipt through resolution in accordance with MVH regulations, guidelines, and quality standards, with expertise in coordination of benefits (COB), DEERS eligibility, and claims development. - Process all MH overseas claim types by determining corrective action to be taken on various types of errors pended by edit system and resolving interactive edits. - Translate, research, and verify claims information to determine if all requirements have been met. - Review submitted claim information and select correct procedure code and diagnosis code using ICD-9, ICD-10, CPT4, and HCPCS manuals. - Obtain development information from external contacts and add successful development information to notepad via PC. - Access patient/sponsor files and update information accordingly. Qualifications - High School Diploma or GED or equivalent experience. - U.S. citizenship is required for this position due to Department of Defense restrictions. - One (1) or more years of experience in a claims processing role. - Demonstrated proficiency in data entry with a strong ability to maintain focus and accuracy. - Ability to effectively utilize available resources to further research and verify claims. - Strong written communication skills. - Demonstrates the ability to work independently and take initiative. Requirements - Ability to translate a foreign language. - Two (2) or more years of prior health insurance experience, i.e., Claims Processor, Customer Service Representative, or Billing Representative preferred. Benefits - Remote work available. - Performance bonus and/or merit increase opportunities. - 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately). - Competitive paid time off. - Health insurance, dental insurance, and telehealth services start DAY 1. - Professional and Leadership Development Programs.

• Determine compensability and/or coverage issues for loss time workers' compensation claims • Effectively manage a caseload of loss time claims from numerous jurisdictions • Negotiate and direct settlements under management's review • Gather medical and factual evidence to determine compensability • Direct outside investigation and handle litigation files within given authority • Coordinate and maintain contact with claimants and/or their attorneys, outside investigators, and rehabilitation personnel as well as routine contact with insureds, account liaisons and medical providers