Strategic Health Insurance Account Specialist

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 individual plans. Provides critical analytical support to the assigned Account Management Team for 51+ sized clients in a fast-paced environment. Serves as the conduit to funnel important information through the company from a client, broker or a consultant perspective related to elevated, previously unresolved, complex situations, as well as general questions and inquiries. Initiates projects, monitors progress, and brings to completion. Responsibilities: Account Administrator I Performs Account Management duties (e.g., Benefit Quote Requests; new business quotes/RFPs; account worksheets; certificate review; WebBen system creation and review; auditing ID cards, rates and system maintenance, groups reporting, etc.). Understands the functions of all areas of the company and builds internal and external networks to navigate problem resolutions. Operates using a multitude of systems and link applications required to successfully perform required job duties. Initiates changes, tracks, and monitors progress of the changes, audits the outcomes of the changes implemented. Interacts with clients, brokers, consultants, internal departments, and vendors to resolve elevated issues related to claims, eligibility, plan design, billing, enrollment, etc. on behalf of customers. Demonstrates diligence in working with internal and external resources to provide effective and efficient closure to open items. Has a clear understanding of internal operations and leverages this knowledge to close-out open issues. Supports with corporate initiatives and directives by releasing any applicable and approved communications, related reporting, and tracks customer feedback in the designated database. Attends client meetings as directed by team management (i.e., open enrollment, wellness, health fairs, and Company-sponsored events, etc.). Presents information before large groups in a confident manner. Maintains awareness of product and process changes; industry trends and any governmental regulatory changes by staying current with updates provided through internal and external sources; actively participating in staff meetings, trainings, and webinars. Performs other duties as assigned. Account Administrator II Performs Account Management duties (e.g., Benefit Quote Requests; new business quotes/RFPs; account worksheets; certificate review; auditing ID cards, rates and system maintenance, groups reporting, etc.). Builds internal and external networks to navigate problem resolution for clients and brokers. Initiates changes, tracks and monitors progress of the changes, audits the outcomes of the changes implemented. Spots trends and educates Team about these developments. Assesses data and provides recommendations based on the analysis. Leads Squad Talks Calls. Resolve complex issues for clients, brokers, and partners across claims, eligibility, plan design, billing, and enrollment. Demonstrates diligence in working with internal and external resources to provide effective and efficient closure to open items. Has a clear understanding of internal operations and leverages this knowledge to close-out open issues Stands in for the Account Executive as needed in the field to present basic information in a concise manner. Resolve problems and implements process/procedure updates to avoid repeating. Supports and assists with corporate initiatives and directives by releasing any applicable and approved communications, related reporting, and tracks customer feedback in the designated database. Makes recommendations to the Team about these processes to streamline outreach. Attends client meetings as directed by team management (i.e., open enrollment, wellness, health fairs, and Company-sponsored events, etc.). Presents information before large groups in a confidentmanner. Conducts training and deploys new processes and procedures along with talking points and other training information take-aways. Navigates pricing discussions with internal and external stakeholders. Conducts departmental/Team training. Maintains awareness of product and process changes; industry trends and any governmental regulatory changes by staying current with updates provided through internal and external sources; actively participating in staff meetings, trainings, and webinars. Performs other duties as assigned. Senior Account Administrator Performs Account Management duties independently and can handle many Account Executive responsibilities. Monitors complex situations and keeps leadership informed and anticipates escalations needs. Builds internal and external networks to resolve client and broker issues. Operates using a multitude of systems and link applications. Initiates, monitors, and audits change implementations. Identifies trends, educates the team, and provides data-driven recommendations. Leads Squad Talks Calls. Resolves escalated client service issues across claims, eligibility, billing, enrollment, and plan design. Coordinates internal and external resources to resolve open issues. Leverages operational expertise to resolve issues, supports Account Executives, and drives process improvements. Supports corporate initiatives through communications, reporting, and customer feedback tracking. Makes recommendations to the Team about these processes in order to streamline outreach. Responsible for training team members and maintaining and creating all AM training manuals/guides to ensure they are accurate and current. They will be a team representative for corporate projects initiatives. Leads client meetings as directed by team management. Presents information before large groups in a confident manner. Conducts training and deploys new processes and procedures along with talking points and other training information take-aways. Navigates pricing discussions with internal and external stakeholders. Conducts departmental/Team training. Maintains awareness of product and process changes; industry trends and any governmental regulatory changes by staying current with updates provided through internal and external sources; actively participating in staff meetings, trainings, and webinars. Performs other duties as assigned. Qualifications: Account Administrator I Education and Experience: Associates Degree in Business Administration, Communications or a related field, or equivalent combination of education/training (minimum high school diploma or GED) and experience. 3 years support experience in a financial service, health insurance, customer service or related environment. Technical Skills and Knowledge: Knowledge of health insurance products and sales and service operations (underwriting, stop loss, benefit plan design, funding). Intermediate Microsoft Office skills (Excel, Word and Power Point). Account Administrator II Education and Experience: Associate Degree in Business Administration or related field. Equivalent combination of education and experience directly related to the role may substitute for a degree. 4 years support experience in a financial service, health insurance, customer service or related environment. Technical Skills and Knowledge: Knowledge of health insurance products and sales and service operations (underwriting, stop loss, benefit plan design, funding). Solid knowledge base of Underwriting rating principles, funding arrangements and renewal developments. Senior Account Administrator Education and Experience: Associate Degree in Business Administration or related field. Equivalent combination of education and experience directly related to the role may substitute for a degree. 6 years support experience in a financial service, health insurance, customer service or related environment. Technical Skills and Knowledge: Knowledge of health insurance products and sales and service operations. Possesses a solid knowledge base of Underwriting rating principals, funding arrangements and renewal developments. 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. 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. 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. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr Superior Dental Care, Inc.