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Superior Dental Care-Claims/Customer Care Specialist
Medical Mutual - Centerville, OH
This position offers a hybrid or remote work option. Note, quarterly on-site requirement in Centerville, Ohio. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We off...
PAR - COB Specialist
Medical Mutual - Toledo, OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
Mgr, IT Infrastructure Transformation
Medical Mutual - Dublin, OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
PAR - Case Manager II
Medical Mutual - Toledo, OH
The Case Manager II position allows you the flexibility to work at home as long as you reside within a 50-mile radius of the Toledo, OH Medical Mutual office. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health...
Care Navigator
Medical Mutual - OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
Clinical Information Specialist
Medical Mutual - OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
Mgr, Sales Reporting
Medical Mutual - Brooklyn, OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
Site Reliability Engineering Manager
Medical Mutual - Dublin, OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
Mgr, Sales Analytics
Medical Mutual - Brooklyn, OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
Regulatory/Contract Lawyer
Medical Mutual - Brooklyn, OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
PAR - Provider Credentialing & Data Specialist II
Medical Mutual - Toledo, OH
Under general supervision, performs typically routine to moderately complex initial and ongoing practitioner, provider, and organization data entry and credentialing into the various modules of the Provider Data Management System. Ensures compliance with standards set by individual states, federal and accrediting organizations and meets production and quality metrics. ESSENTIAL FUN...
IT Operations Technician I-IV
Medical Mutual - Columbus, OH
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and indivi...
PAR - Medical Coding Compliance Specialist
Medical Mutual - Toledo, OH
Job Summary: Optimizes/reviews documentation for the application of risk adjustment coding for ACA (Affordable Care Act) and MA (Medicare Advantage) with assigning and maintaining diagnoses medical codes. Evaluates requests for adherence to Company policies for the most precise medical codes. Audits vendors for quality assurance of risk adjustment coding f...
PAR - Claims Representative II
Medical Mutual - Toledo, OH
Job Summary: 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 and adheres to quality standards to meet Company and departmental goals.
COB Specialist
Medical Mutual - OH
Responsibilities COB Specialist I Researches and responds to inquiries/issues to ascertain specifics of multiple health insurance coverages for members and dependents. Contacts membership, providers, and other insurance companies to gather coordination of benefits (COB) data. Determines source of problem, impact to customers, and resolution. ...
