Certificate Dev Spec I-II Job Listing at Medical Mutual in United States of America (Job ID 2400466)

Description

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 individual plans.  

Medical Mutual' s status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us and help our members achieve their best possible health and quality of life.

Certificate Development Specialist I

Participates in an on-the-job training program in order to prepare routine and/or standard documents (certificates of coverage) describing benefits for fully insured health plans.

Certificate Development Specialist I

Prepares and revises varied and/or non-standard documents (certificate books) describing benefits for less complex self-funded to moderately complex fully insured health plans.

Responsibilities 

Certificate Development Specialist I

• Receives extensive training on the Company's products and related certificates of coverage and the certificate publishing system and the use of the Corporate Management System (CMS) as it relates to certificates.
• Creates standard schedules of benefits and certificates of coverage within required timeframe.      
• Responds to questions from the sales area pertaining to certificates.
• Monitors progress of certificate review and approval, follows up as needed and documents status in database.
• Performs other duties as assigned.

Certificate Development Specialist II

• Develops certificate language in understandable terms, while ensuring it meets the customers' needs and complies with all state and federal laws.
• Responds to questions from the sales area pertaining to certificates and ensures appropriate approvals are received on a timely basis.    
• Ensures that benefits being proposed by Sales are within approved state filings and in accordance with state and federal mandates.
• Develops benefit books for less complex self-funded plans.
• Monitors progress of certificate review and approval, follows up as needed and documents status in database.
• Coordinates print production of certificates and books with internal resources.
• Performs other duties as assigned.

Qualifications

Certificate Development Specialist I

Education and Experience:

• Bachelors' Degree in Journalism, English, Business Administration or related field preferred, or equivalent combination of training and experience.     
• 1 year experience in health insurance operations which provides exposure to certificates of coverage and schedules of benefits.

Technical Skills and Knowledge:

• Knowledge of health insurance benefits and legal terminology.
• Ability to interpret and apply English language skills in the preparation of legal documentation.
• MS Office skills and proficiency with database management software.

Certificate Development Specialist II

Education and Experience:

• Bachelors' Degree in Journalism, English, Business Administration or related field preferred, or equivalent combination of training and experience.
• 2 years experience as a Certificate Development Specialist or equivalent experience in the development of health insurance certificates of coverage and/or other contracting documentation.

Technical Skills and Knowledge:

• Knowledge of health insurance benefits, legal terminology and related state insurance laws.
• Intermediate MS Office skills and proficiency with certificate publishing systems.
• Ability to interpret and apply English language skills in the preparation of legal documentation.

Medical Mutual is looking to grow our team! 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:

• We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide 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 individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.

At Medical Mutual and its family of companies 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.