Claims Processing Services
Efficient claims processing is critical to the success of healthcare payer organizations. MHC Services Group provides scalable claims processing solutions tailored to meet the challenges of today’s dynamic healthcare environment. Our expert teams help clients manage overflow, improve accuracy, and ensure compliance, allowing payer organizations to focus on their core operations while optimizing efficiency and outcomes.
Transform Claims Management with MHC’s Expertise and Scalable Solutions
MHC offers a range of claims processing services designed to empower healthcare payers to address their unique challenges. Our deeply experienced professionals collaborate with clients to provide the right resources at the right time, ensuring accuracy, timeliness, and cost-effectiveness. Whether it's managing overflow, addressing staffing shortages, or handling the entire claims process, MHC’s solutions are tailored to align with your organizational goals and deliver measurable results.
Our approach is built on years of industry expertise, advanced technology, and a commitment to client success. We prioritize compliance, risk management, and operational efficiency, making MHC an invaluable partner in navigating the complexities of claims processing.
Where We Focus
Full-Service Claims Management
Comprehensive management of the entire claims process from intake to final adjudication.
Experienced claims examiners and management teams focused on achieving optimal efficiency and accuracy.
Project Management and Governance
Governance (Program and Project Management)
Vendor Management and Budgets
Claims Overflow Support
Augmentation of existing claims teams to reduce backlog and streamline processing.
Cost-effective solutions to manage temporary or seasonal increases in claims volume.
Technical Services
Requirements Development (Business and Technical)
Configuration (Data Loading and Data Validation)
Data Conversion, (Data Loading and Data Validation)
Staff Turnover Services
Expert staffing support during transition periods, ensuring uninterrupted claims operations.
Access to management support and claims examiners at all levels to maintain quality and capacity.
Testing and Quality Assurance
Testing (Unit, Production, Integrations, Regression, and Product Release Testing)
Add-On Services
Root Cause Analysis: Analytics-driven identification of denial patterns to prevent future issues.
Operational Support: Mailroom, check processing, auditing, and fulfillment services to enhance efficiency.
Training and Support
Training (Product, Processes, and Technical)
Go Live and Post Go Live Support
Healthcare Business Consulting Insights
Business and Operational Services
MHC works with our clients to understand their specific needs and align our professional services teams to support their culture, unique technical and business requirements to ensure cross-team collaboration that is focused on a clear and achievable set of deliverables and timelines supporting optimal outcomes and experiences.
Implementation Services
MHC provides comprehensive healthcare payer software implementation services and support for successful transformation. Our services cover core administrative processing systems, care management, portals, data warehouse, and other ancillary systems. We offer executive governance, program management, analytics, process improvement, configuration, testing, and training services.
Technical Support Services
MHC provides design, layout, deployment, fabrication, and integration of interactive technologies into both new and pre-existing environments. We provide a proven, practical approach that yields quality and excellence for our clients to maximize their ROI based on process-oriented frameworks, enabling operational business transformations to ensure qualitative deliverables and improved efficiency.
System Run Out Services
MHC’s System Run Out Services differ from many other types of service delivery solutions, in that it provides a comprehensive set of proven, targeted services to bridge gaps with support from a team of experts to enhance your current team during the transition from your legacy systems to new systems.