Foreign Claims Processor

Role Snapshot 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. Additional Details Start Date: Tuesday August 11 Starting Base Salary: starting at $18.50/hour (may fluctuate with experience) Training Schedule: 8:00am-4:35pm CST Monday‑Friday (4 weeks) Scheduled Shift: Flexible schedule once metrics have been obtained, 8‑hour shifts between 6am‑10pm CST During Probationary Period: 8:00‑4:35pm CST Mon‑Fri Work Location We are open to remote work in the following approved states (training will also be remote): Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin Responsibilities 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. Minimum 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. Preferred Qualifications 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. Remote Work Requirements Wired (ethernet cable) internet connection from your router to your computer. High speed cable or fiber. Minimum 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at speedtest.net). Please review Remote Worker FAQs for additional information. 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. Review additional benefits: Regulatory Information This position supports services under U.S. Department of Defense (DoD) Defense Health Agency (DHA) contract(s). As such, the role is subject to all applicable federal regulations, DoD contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. DoD contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services. Equal Employment Opportunity Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr WPS Health Solutions