Technical Operator III

🕒 May 4

🇺🇸 United States – Remote

💵 $21 - $24 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

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MedRisk

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1994

⚕️ Healthcare Insurance

🤝 B2B

☁️ SaaS

Healthcare Insurance • B2B • SaaS

MedRisk is a managed care organization that specializes in improving recovery and payment integrity for workers' compensation and occupational injury cases. The company combines clinical triage, scheduling, patient engagement, network management, and analytics to connect patients with appropriate care, streamline authorizations, and deliver secure electronic payments. MedRisk provides services and technology platforms for payers, providers, and patients to optimize spending, ensure compliance, and translate data into actionable insights.

📋 Description

• Evaluate, negotiate, and settle workers’ compensation claims in compliance with applicable laws and internal policies. • Review and analyze medical bills, treatment records, and claim documentation to determine appropriate settlement values. • Negotiate with medical providers, and other parties to reach fair and timely resolutions. • Ensure compliance with all applicable state workers’ compensation laws and regulations. • Maintain accurate and up-to-date documentation of negotiations and outcomes in the claims management system. • Identify potential cost-saving opportunities and work toward minimizing claim exposure. • Communicate clearly and professionally with both internal and external contacts. • Monitor claims to identify trends and report on potential areas of concern.

🎯 Requirements

• 2–5 years of experience in workers’ compensation claims handling, bill review, or negotiation (or equivalent combination of education and experience). • Strong knowledge of workers’ compensation regulations and fee schedules. • Strong understanding of medical billing codes (CPT, ICD-10, HCPCS), state fee schedules, and PPO discounts. • Excellent communication and negotiation skills, both written and verbal. • Strong attention to detail and ability to manage multiple cases independently. • Proficient with claims management systems and Microsoft Office Suite.