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MMU Representative
Career Insights for Medical Claims Processor / Representative
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Based on Virginia data
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$48,611 / year median in Virginia
-5% projected decline
Job Description
MMU Representative
Location:
Company:
POSITION TITLE
MMU Representative STATUS:
Non-Exempt
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.
Pursue professional development
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 claims work experience
Previous experience in investigation, evaluation, and reserving techniques
MINIMUM SKILL QUALIFICATIONS
Previous experience with online and stand-alone computer systems
Proven customer service skills
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.