Job Information
Medical Mutual of Ohio Family Medical Leave Administrator in Brooklyn, 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 1.2 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.
Adjudicates claims for all life and disability products in the Life Insurance Company's book of business. Provides professional customer service to claimants, doctors, internal and external customers. Approves or denies claims within scope of authority; recommends course of action to Manager.
This position has the option to work hybrid; Northeast Ohio residents preferred. Seeking applicants that possess family medical leave administrative experience.
Responsibilities
Family Medical Leave Administrator (Level II, Senior)
Interprets and administers leave programs and policies in accordance with applicable federal and state employment laws.
Manages Sick Leave Supplemental Programs in accordance with designated leave policies.
Advises, counsels, and educates employees on leave policies, procedures, and programs.
Informs employees of eligibility status.
Coordinates and organizes all medical information and ensures that HIPAA and Employee Privacy guidelines are effectively executed.
Manages all administrative aspects of leave claims and works closely with Payroll and department timekeepers to ensure that leave processing is accurate.
Produces and manages reporting metrics and analytics for all leave programs. Provides reports as requested.
Maintains confidentiality of sensitive information.
Must comply with all HIPAA rules regarding authorized use, training, storage and destruction of PHI.
Researches and remains aware of changes of applicable laws (i.e.: FMLA, HIPAA, ADA, etc.).
Maintains and properly stores/destroys leave records in compliance with record retention policies/procedures.
Performs other duties as assigned.
Qualifications
Family Medical Leave Administrator II
Education and Experience
Bachelors’ Degree in Business or Healthcare Administration or related field preferred, but will consider collective experience, training and education.
3 years experience as a Life & Disability Benefits Specialist or equivalent life and disability claim processing/customer service, preferably in a group insurance setting.
Professional Certification(s)
- Life Office Management Association, Health Insurance Associate, Insurance Claims Adjuster (LOMA, HIA, ICA) coursework preferred.
Technical Skills and Knowledge
Intermediate Microsoft Office and claims processing/customer service applications skills.
Thorough knowledge of life and disability products/services.
Thorough knowledge of, and the ability to interpret and apply regulations and Company policies related to leaves of absence, disability, workers compensation, etc.
Knowledge of Family and Medical Leave Act (FMLA) and Americans with Disabilities Act (ADA).
Understanding of medical terminology and insurance contracts.
Senior Family Medical Leave Administrator
Education and Experience
Bachelors’ Degree in Business or Healthcare Administration or related field preferred, but will consider collective experience, training and education.
5 years progressive experience as a Life & Disability Benefits Specialist or equivalent life and disability claim processing and customer service experience, preferably in a group insurance setting.
Professional Certification(s)
- Life Office Management Association (LOMA) or Health Insurance Associate(HIA) Insurance Claims Adjuster (ICA) coursework preferred.
Technical Skills and Knowledge
Thorough knowledge of Family and Medical Leave Act (FMLA) and Americans with Disabilities Act (ADA)
Intermediate to advanced Microsoft Office and claims processing/customer service applications skills.
Thorough knowledge of life and disability products/services.
Thorough knowledge of, and the ability to interpret and apply regulations and Company policies related to leaves of absence, disability, workers compensation, etc.
Extensive knowledge and understanding of insurance contracts, medical terminology and medical conditions (also co-morbid) as it relates to applying disability durations.
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.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
Title: Family Medical Leave Administrator
Location: OH-Brooklyn
Requisition ID: 2400334
