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Jobs at Medical Mutual

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Provider Service Representative II

Medical Mutual - Brooklyn, OH

Collaborates with providers and across internal departments on quality improvement activities aimed at improving accuracy of claim processing, reducing provider inquiries, and driving operational efficiencies – for health systems and internally, ultimately improving the provider and member experience. Serves as an operational subject matter expert, both internally and to providers. Helps the...

Software Developer IV (COBOL Developer)

Medical Mutual - Brooklyn, OH

Leads the process of translating user requirements and systems objectives of increasing complexity into a logical, efficient and optimal systems design. Develops and maintains new and existing applications by writing code based on the aforementioned design to ensure that business rules, security standards and government regulations are met. Provides management with recommendations ...

Claims Representative II

Medical Mutual - Brooklyn, OH

Processes claims in accordance with benefit contracts, plan policies and production/quality goal requirements. Performs administrative duties as requested by management. Responsibilities Processes claims edits from receipt to completion. Utilizes claims and ancillary systems and adheres to processing procedures resulting in the final...

Director, Medicaid Pharmacy (Pharmacist)

Medical Mutual - Cleveland, OH

Medical Mutual provides health insurance to more than 1.6 million Ohioans. For more than 85 years, the Company has improved the lives of its members by offering high-quality group and personal healthcare coverage. Medical Mutual is seeking a talented Director that owns Medicaid Pharmacy benefit including identification and implementation of Ohio Department of Medicaid...

Sr Provider Experience Program Analyst

Medical Mutual - Cleveland, OH

Evaluates inputs from corporate initiatives, business goals, department and company stakeholders and provider feedback in order to develop, maintain and promote the Product Roadmap(s) and Provider Journey maps. Leads the discovery and intake phases of product planning and manages or participates in related processes around prioritization, definition, and product strategy. Develop...

Provider Network Reporting Coordinator

Medical Mutual - Cleveland, OH

Evaluates incoming data requests from internal sales, contracting and other departments for provider geographic availability, disruptions and other ad hoc needs. Manages work queue and maintains activity log. Assigns requests to appropriate staff member for completion. Reviews and tracks completed requests before returning to requestor. Receives and evaluates tier data informatio...

Senior Claims/Customer Care Specialist-TPA

Medical Mutual - Brooklyn, OH

Processes routine to complex healthcare claims and responds to inquiries from third party administration and/or ancillary product services customers regarding benefits, coverage or claim status in accordance with established performance expectations and service philosophy. Responsibilities Processes routine to complex healthcare claims and/or...

Lead Claims/Customer Care Specialist-TPA

Medical Mutual - Brooklyn, OH

Processes routine to complex claims and adjustments and responds to written or phone inquiries from third party administration and/or ancillary product customers regarding benefits, coverage or claim status. Assists with mentoring of team members, triages escalated issues and assists team members with problem resolution. Responsibilities Proc...

Supervisor, Customer Experience Learning & Development

Medical Mutual - Brooklyn, OH

Leads instructional design team responsible for the design and development of highly effective training programs using proven adult learning methodologies. Acts as liaison between business areas to determine training requirements and resolve issues. Evaluates existing instructional methods and design processes for feasibility and opportunities for improvement. Resp...

VP, IT Infrastructure, Operations and Cybersecurity

Medical Mutual - Brooklyn, OH

Responsibilities The VP, IT Infrastructure, Operations and Cybersecurity leads the strategy, development, implementation and oversight of Medical Mutual's Technology Infrastructure. The position is operationally responsible for ensuring the availability, integrity, scalability, and security for all IT systems and infrastructure. This is a key execu...

Customer Care Specialist (Service Consultant)

Medical Mutual - Brooklyn, OH

We are hiring for our Brooklyn office! The start dates for these positions will be in March 2021. Participates in up to a year-long formal call center training program that provides knowledge and skills needed to resolve and respond to customer inquiries regarding the Company's health insurance products and services. Navigates systems and provides customer service in ac...

Account Administrator - Cleveland

Medical Mutual - Cleveland, OH

Provides administrative support to assigned 51 group sales and/or service team in a fast-paced environment. Serves as the first line of communication between the client, prospect, broker or consultant for questions and inquiries. Responsibilities Performs sales and service administrative tasks (i.e. Benefits Quote Requests, new business quotes...

IT Analyst IV

Medical Mutual - Brooklyn, OH

The Senior IT Asset Analyst works under minimal supervision and performs Software Asset analysis for the ITAM Organization. The Sr. Analyst will lead the processing, accounting and management of IT software maintenance and hosting/SaaS across the enterprise. This position interacts primarily with our management, vendors and IT Procurement for process/transactional activity. Res...

Software Developer IV

Medical Mutual - Cleveland, OH

Leads the process of translating user requirements and systems objectives of increasing complexity into a logical, efficient and optimal systems design. Develops and maintains new and existing applications by writing code based on the aforementioned design to ensure that data integrity, data quality, business rules, security standards and government regulations are met. Provides management w...

SCCM Administrator (Infrastructure Engineer II)

Medical Mutual - Brooklyn, OH

Ensures reliability and stability of assigned platforms and systems. Completes technical tasks, troubleshoots issues, provides input on methods and systems, provides off hours support (on-call) as a part of a rotation, under general supervision. Completes service requests and maintenance support in a timely manner. Packages, tests, and deploys software using SCCM packages and...