Medical Payments Spec

Job Title

Join an amazing team that is consistently recognized for our achievements and culture, including our most recent Forbes award of being one of America's Best Midsize Employers for 2025!

An in-person interview may be required during the hiring process.

We welcome applicants from across the U.S.; however, candidates who reside in the Pacific Standard Time (PST) zone are strongly preferred to support team collaboration and business hours alignment.

Our next class start date is January 26, 2026, and consists of 4 weeks of paid training.

Under moderate supervision, evaluates, investigates, and adjusts routine Medical Payments (MP) coverage claims in a timely and efficient manner. Review medical bills and primary health carrier explanation of benefits to determine the amount owed and issues appropriate payments under MP coverage. Responsible for MP exposures from initial report of injury through final payment. Maintain diary of files in pending and update file information to ensure accurate record of claims; continually reviews and monitors progress and expense of claims in pending.

Responsibilities

Essential Job Functions :

• Initial contact with injured persons to explain MP coverage, maintain 30-day contact including updating status letter language, follow-up for medical bills and primary health carrier explanation of benefits forms. Review medical bills and primary health carrier explanation of benefits forms to determine patient responsibility and issue payments.
• Complete ISO / Medicare reporting on injured persons. Coordinates with third party carriers for status of BI settlement to ensure subrogation potential for medical payment reimbursement.
• Regular attendance at work on a full-time schedule of at least 8 hours and 40 hours per week
• Other functions may be assigned

Qualifications

Education :

High School Diploma or GED

Preferred : Associate degree

Experience :

6+ months customer service experience.

Preferred : Associate degree

Background in or knowledge of the processing of medical claims.

Skills & Abilities :

Solid comprehension of basic principles and practices of Company policies upon completion of formal and informal training.

Ability to multi-task in a fast-paced environment, prioritize responsibilities, and deliver accurate work-product to expedite claims resolution and manage a high volume of claims.

Has a passion for serving customers in their time of need.

Possesses effective written and verbal communication skills to professionally represent the Company in multi-channel correspondence with customers, claimants, and other insurance carriers.

Independently makes high-quality claims adjusting decisions.

Collaborates well with others. We are one team with a common goal.

Ability to build rapport utilizing emotional intelligence.

Views conflict resolution as an opportunity.

Has self-motivation and accountability while working remotely.

Demonstrated proficiency with MS Office products (Outlook, Word, Teams) and claims related software.

Must have dedicated workspace that is free from distractions.

Preferred : Associate degree

Takes ownership of any process they can improve.

Assumes positive intent in all interactions.

Seeks growth within and beyond this role.

About the Company

At Mercury, we have been guided by our purpose to help people reduce risk and overcome unexpected events for more than 60 years. We are one team with a common goal to help others. Everyone needs insurance and we can't imagine a world without it.

Our team will encourage you to grow, make time to have fun, and work together to make great things happen. We embrace the strengths and values of each team member. We believe in having diverse perspectives where everyone is included, to serve customers from all walks of life.

We care about our people, and we mean it. We reward our talented professionals with a competitive salary, bonus potential, and a variety of benefits to help our team members reach their health, retirement, and professional goals.

Perks and Benefits

We offer many great benefits, including :

Mercury Insurance is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other characteristic protected by federal, state, or local law.

Pay Range

USD $31,574.00 - USD $55,318.00 / Yr.