Senior Cobra Benefits Admin TPA

Job Title

Medical Mutual employees must submit their applications through MySource.

Note: This is a remote position however, candidates must reside in the Cleveland/Brooklyn, Ohio area.

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.

Job Summary

Under limited supervision, administers routine to complex Flexible Spending Accounts (FSA) claims, Health Reimbursement Accounts (HRA) claims, and/or continuation of health coverage (Cobra) enrollments, adjustments, and related processes. Responds to written or phone inquiries regarding benefits, coverage, State and Federal guidelines, Internal Revenue Service (IRS) guidelines, and/or submission status.

Responsibilities

• Processes FSA, HRA, and/or COBRA claims, adjustments, and payments and handles inbound/outbound phone calls.
• Responds to written inquiries.
• Coordinates check runs, enrollment transactions, electronic files, contributions, and works with banking processes.
• Research and updates department documentation regarding State and Federal Statutes, IRS changes, and The Department of Labor (DOL) updates. Prepares and updates Standard Operating Procedures (SOPs).
• Orients, trains, and assists more junior level team members.
• Initiates, provides input, and leads implementation efforts for process improvement.
• Assists in auditing of case and benefit plan builds or other special projects.
• Enhances knowledge of departmental processes and industry standards.
• Performs other duties as assigned.

Qualifications

Education and Experience:

• Associate Degree in Business or Healthcare Administration or equivalent combination of education/training and experience.
• 3 years of experience as a Specialty Benefits Administrator-TPA or equivalent experience in health/specialty benefits claims processing and/or customer service, membership, or billing, preferably in third party administration.

Technical Skills and Knowledge:

• Intermediate Microsoft Office (especially Excel) and medical claims processing systems skills.
• Strong knowledge of health insurance products and medical terminology.
• Strong math skills.
• Strong knowledge of continuation of health coverage (COBRA) and IRS regulations.
• Ability to interpret various types of claims reimbursement and enrollment forms.

Benefits

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.

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.