Medical Mutual of Ohio Claims Customer Care Specialist II in Copley, Ohio

Process routine to moderately 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.


· Processes Routine to moderately complex healthcare claims and /or adjustments while providing customer service via inbound/outbound phone calls and written communications

· Under direction of more senior staff, conducts routine claims research in response to inter/intra-departmental inquiries

· Assists with projects as directed by management

· Performs other duties as assigned

· Associate Degree in Business Administration, Communication or related field or equivalent combination of training and experience

· 2 years’ experience as a Claims/Customer Care Specialist or equivalent customer service experience in the health insurance industry. Third Party Administration experience a plus

· Healthcare field certifications a plus

· Basic MS Office skills

· Knowledge of third party administration/ancillary product, services, polices procedures and system.

We truly value and respect the talents and abilities of all of our employees. That’s why we offer an exceptional package that includes

A Great Place to Work

· Top Workplace in Northeast Ohio. Five years in a row we’ve received this recognition!

· Employee discount program. Discounts at many places in and around town, just for being a Medical Mutual team member

· Business casual attire

Excellent Benefits and Compensation

· Competitive compensation plans

· Employee bonus program

· Healthcare

· 401(k) with company match and an additional company contribution

· Excellent medical, dental, vision, and disability insurance

An Investment in You

· Career development programs and classes

· Mentoring and coaching to help you advance

· Education reimbursement up to $5K per year

About Medical Mutual

We strive to create peace of mind. Our customers can trust us to do things right and to help them get value from their health plan. We’re the largest health insurer in Ohio and for 80 years, we’ve been serving our members and the Ohio communities where they live and work. Medical Mutual is a Top Place to Work in Northeast Ohio with exceptional career opportunities that offer challenge, growth and a great work/life balance. We want talented, innovative, and driven people to help us continue to be the best health insurance choice of Ohioans and help make Ohio the best it can be! Our headquarter building is located in the heart of downtown Cleveland and we have multiple offices throughout the state. Join us at one near you!

At Medical Mutual we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

Title: Claims Customer Care Specialist II

Location: OH-Copley

Requisition ID: 1800062