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Jobs at Medical Mutual

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Supervisor, TPA Operations

Medical Mutual - Brooklyn, OH

Coordinates the activities of, and provides staff the appropriate tools and training to support all applicable customer experience interactions. Coaches, develops and fosters a highly effective team, ensuring established goals and standards are met. Manages daily workload to uphold productivity levels, quality outcomes, inventory volumes, performance guarantees, timeliness measures, customer...

Lead Emp Group Consulting Analyst*

Medical Mutual - Cleveland, OH

External Notice Medical Mutual of Ohio seeking Lead Employer Group Consulting Analyst to lead the design and execution of analyses and reports that identify opportunities to improve care and lower costs in Cleveland, Ohio. Will analyze data, create reports and present results to client to inform decision-making; will collaborate with internal teams to execute rel...

Contracting Coordinator

Medical Mutual - Columbus, OH

Assists Contractors and Management by maintaining familiarity with each account and their designated representative(s), understanding provider contracts, and fielding calls/concerns that occur. In addition, prioritizes and researches problems affecting providers and maintains up to date contract and contract management files and documentation Responsibilities

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...

Operations Quality Specialist-TPA

Medical Mutual - Brooklyn, OH

Evaluates routine to complex transactional work of claims and/or customer service staff, assessing and documenting adherence to service level agreements and corporate service philosophy and standards. Identifies and reports on trends and makes recommendations to improve overall quality and direct training focus. Works with management as a change agent to implement process improvements. ...

Business Systems Analyst II

Medical Mutual - Brooklyn, OH

Provides the interface between the business and information technology areas with an understanding of priorities and high-level concerns of both areas. Works with business partners to analyze/prioritize business requirements and review/produces specifications for any change to technology applications. Works with the systems development team throughout the project life cycle to ensure t...

Automation Developer I

Medical Mutual - Brooklyn, OH

Partners with other automation developers, business systems analysts, and liaisons to translate user processes into a logical, efficient and optimal process designs. Develops and maintains new and existing automations by building UI maps, creating process flows and writing code based on the design to ensure that business rules, security standards and government regulations are met. Esc...

Sr Medicare Compliance Auditor

Medical Mutual - Cleveland, OH

Maintains knowledge of current Medicare Advantage Audit Guides, Audit Protocols as well as Medicare Advantage Part C and Part D Reporting Requirements. Working knowledge of industry regulatory issues and how they affect the Company. Performs Medicare audits including review of data extraction procedures and data analysis. Documents findings and recommendations to determine org...

Contracting Coordinator

Medical Mutual - Rossford, OH

Assists Contractors and Management by maintaining familiarity with each account and their designated representative(s), understanding provider contracts, and fielding calls/concerns that occur. In addition, prioritizes and researches problems affecting providers and maintains up to date contract and contract management files and documentation. Responsibilities

Chief Growth Officer- Bravo Wellness

Medical Mutual - Cleveland, OH

*This position is for Bravo Wellness and can be located anywhere in the U.S.* Summary Identifies and delivers new revenue opportunities in the wellness market; growing revenue from developing relationships for new business, ensuring client satisfaction and contracts renew, lead generation and marketing campaigns and being a voice of the customer collaborating w...

Manager, TPA Information Systems

Medical Mutual - Brooklyn, OH

Optimizes a significant suite of Specialty TPA Systems, technology platforms, vendors and infrastructure that are key to enabling the Specialty TPA customer experience. Manages the operations and staff responsible for Specialty TPA customer care integrated systems, automated processes, and related vendor relationships. Acts as the primary liaison with IT to implement process improvements max...

Account Administrator

Medical Mutual - Brooklyn, 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 QA Tester/Quality Analyst IV

Medical Mutual - Brooklyn, OH

Works on a dedicated scrum team to assure projects meet quality standards by planning, designing and executing appropriate test plans. Participates in estimating user stories, daily stand ups, and sprint planning sessions. Collaborates with the Product Owner (PO) to write acceptance criteria. Collaborates with developers on continuous user story delivery with fast feedback ...

Business Systems Acceptance Coordinator

Medical Mutual - Brooklyn, OH

Develops and executes test plans and matrices according to plan specifications and requirements. Verifies the quality, accuracy and integrity of new systems and/or system enhancements. Responsibilities Develops test conditions creating a detailed summary of each test case including expected results. Executes test cases according to test plan and ...

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 ...