Process, investigate, evaluate, reserve, adjust, and negotiate medical expense and Med Pay claims. Maintain Medicare reporting information, respond to correspondence, support claims personnel, handle phone inquiries, and develop relationships with medical professionals, attorneys, vendors, and court personnel. The role requires claims experience, analytical and communication skills, strong organization, attention to detail, and the ability to work independently.
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.
Similar Jobs
Gaming • Information Technology • Mobile • Software • Esports
Lead the DevOps team for WWE 2K by defining technical strategy and building reliable development and production infrastructure. Responsibilities include designing CI/CD pipelines, deployment automation, cloud and containerized environments, developer tooling, observability, documentation, and operational standards. The role also requires cross-team collaboration, technical leadership, and improving workflows across a distributed game development studio.
Top Skills:
.NetAWSBashCC#C++Ci/CdGCPGitInfrastructure As CodeJenkinsLinuxNode.jsPerforcePowershellPuppetPythonReactWindows
Blockchain • eCommerce • Fintech • Payments • Software • Financial Services • Cryptocurrency
Lead Block’s Compliance Issues Management Oversight program across Square, Cash App, and Afterpay. Own remediation tracking, change governance, scope determinations, quality assurance, escalation, reporting, and closure validation for compliance issues involving AML/BSA, sanctions, and consumer protection. Build governance standards, procedures, templates, and playbooks; facilitate cross-functional forums; advise stakeholders; and scale the program through AI, automation, and workflow tooling.
Top Skills:
AICompliance Issue Management SystemsGovernance Reporting ToolsWorkflow Automation
Blockchain • eCommerce • Fintech • Payments • Software • Financial Services • Cryptocurrency
Own Square Hardware’s US retail channel strategy, sales, revenue, and retailer partnerships. Responsibilities include managing existing relationships, sourcing and negotiating new partnerships, developing go-to-market playbooks, forecasting sell-through, coordinating cross-functional launches, and managing retail marketing budgets. The role requires entrepreneurial execution, analytical decision-making, autonomy, and approximately 20% travel.
Top Skills:
AfterpaySquare Hardware
What you need to know about the Colorado Tech Scene
With a business-friendly climate and research universities like CU Boulder and Colorado State, Colorado has made a name for itself as a startup ecosystem. The state boasts a skilled workforce and high quality of life thanks to its affordable housing, vibrant cultural scene and unparalleled opportunities for outdoor recreation. Colorado is also home to the National Renewable Energy Laboratory, helping cement its status as a hub for renewable energy innovation.
Key Facts About Colorado Tech
- Number of Tech Workers: 260,000; 8.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Lockheed Martin, Century Link, Comcast, BAE Systems, Level 3
- Key Industries: Software, artificial intelligence, aerospace, e-commerce, fintech, healthtech
- Funding Landscape: $4.9 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Access Venture Partners, Ridgeline Ventures, Techstars, Blackhorn Ventures
- Research Centers and Universities: Colorado School of Mines, University of Colorado Boulder, University of Denver, Colorado State University, Mesa Laboratory, Space Science Institute, National Center for Atmospheric Research, National Renewable Energy Laboratory, Gottlieb Institute
