For 27 years, we've been the trusted backbone of claims management — processing over $5 billion in payments for employers, TPAs, and MCOs nationwide. Now enhanced with AI-powered intelligence.
Founded in Cleveland, Ohio in 1998, MCO Advantage has been at the forefront of claims management innovation for over two decades. We've processed millions of claims totaling over $5 billion in payments, serving as the trusted technology partner for employers, TPAs, and MCOs nationwide.
27+ years of proven industry leadership in claims management and healthcare administration technology.
AI phone integration for customer service and AI document intelligence.
Continuously evolving our platform with cutting-edge AI and machine learning capabilities.
From workers' compensation to healthcare administration, our integrated platform handles every aspect of your claims lifecycle with unmatched precision and efficiency.
Comprehensive claims processing solution for group health plans with seamless marketplace integration and secure data handling.
Our flagship comprehensive workers' compensation and claims management platform — trusted by employers, TPAs, and MCOs nationwide.
Advanced document imaging and management platform with remote scanning capabilities and 24/7 access from any device.
Patented CDHP/HSA self-funded health plan administration with point-of-service adjudication and payment processing.
OBWC Qualified Wellness Vendor program designed to improve employee health outcomes and reduce workers' compensation costs.
Next-generation wellness tool that replaces traditional HRA with comprehensive health analytics and personalized recommendations.
Leveraging cutting-edge artificial intelligence and machine learning to transform how claims are processed, analyzed, and managed. Our AI-powered platform delivers unprecedented efficiency, accuracy, and insights.
Intelligent document processing with OCR, data extraction, and automatic classification for faster claims processing.
Machine learning algorithms automatically route claims to the right adjusters based on complexity, expertise, and workload.
Advanced predictive models identify high-risk claims early, enabling proactive intervention and cost reduction.
AI-driven compliance monitoring ensures adherence to regulations and automatically flags potential issues.
Discover what sets us apart from the competition and why industry leaders trust us with their most critical claims operations.
Comprehensive marketplace health plan administration with seamless integration and compliance management.
Integration with CMS
Purpose-built technology for health sharing organizations with streamlined member management and cost sharing workflows.
ShareBox Processing
Cutting-edge artificial intelligence woven throughout the platform — from intelligent document processing to predictive analytics and automated compliance.
Complete claims management from first notice of injury through final settlement, with real-time connectivity and seamless data flow between all stakeholders.
27+ years of continuous innovation, $5+ billion in processed claims, and the trust of employers, TPAs, and MCOs nationwide demonstrate our unwavering commitment to excellence.
Our comprehensive platform serves diverse industry verticals with specialized solutions tailored to unique regulatory and operational requirements.
Decades of proven results and billions in payments processed — our success is measured by your success.
Don't just take our word for it. Hear from industry leaders who trust MCO Advantage with their most critical operations.
"We are very pleased with all aspects of Claims Advantage™ - they provide excellent service, and a great tool that has allowed us to grow our business considerably and lower our cost. Mature software that really works."
"Claims Advantage™ is far superior to our previous software in its capacity to quickly and efficiently process case management information and transmit data to the Ohio Bureau of Workers Compensation."
"Claims Advantage™ is an easily learned system. In most cases, new employees can be trained in one day. System support is excellent."
"We are very pleased with our decision to move to Claims Advantage™ - they have provided excellent service and a great tool that has allowed us to grow our business considerably."
Decades of combined experience in claims management, technology, and healthcare — driving innovation since 1998.
President & CEO
Founded MCO Advantage in 1998 in response to the evolving workers' compensation marketplace. Under his leadership, MCO Advantage has grown to serve employers, TPAs, and MCOs nationwide with innovative claims management solutions.
Senior Vice President & CTO
Co-founded MCO Advantage and oversees the development and implementation of all software applications. Brings 20+ years of software development and consulting experience, including five years with Ernst & Young's Consulting Services Group.
IT Director & VP Client Services
Administers all IT operations including network management, server operations, and internal support. Manages the Client Services Support Team and is instrumental in maintaining client relationships.
Our strategic alliances with industry leaders ensure you receive best-in-class technology and support.
Leveraging IBM's enterprise-grade technology and innovation for unmatched reliability and performance.
Join our growing network of certified partners and expand your service offerings with proven technology.
Learn MoreTrusted by employers, TPAs, and MCOs across all 50 states. Let's discuss how our platform can transform your claims operations.
216.283.7999
Speak directly with our solutions experts
sales@pbmcorp.com
Get detailed information and proposals
Tower East
20600 Chagrin Blvd, Shaker Heights, OH 44122