Member Services Coordinator

Medical Mutual; Cleveland, Christiansted (OH, United States Virgin Islands); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player in health insurance is seeking a dedicated individual to support counseling services. This role involves managing resource requests, collaborating with counselors, and maintaining essential records. The company values its employees and offers a supportive work environment with access to fitness centers, generous benefits, and career development opportunities. Join a team committed to providing high-quality healthcare solutions to over 1.2 million members and make a meaningful impact in the community.

Benefits

Gym Membership Reimbursement

On-site Cafeteria

Employee Bonus Program

401(k) with Company Match

Tuition Reimbursement

PTO Days

Parental Leave

Career Development Programs

Discounts at Local Businesses

Business Casual Attire

Qualifications

• Associates Degree or equivalent experience in a related field.
• 3 years of experience in clinical operations support.

Responsibilities

• Manage resource requests and referrals for counseling services.
• Collaborate with providers and maintain records in case management systems.

Skills

Customer Service

Communication Skills

Data Entry

Organizational Skills

Education

Associates Degree in Business or Healthcare Administration

3 years clinical operations support experience

Tools

Microsoft Office (Word, Excel, Outlook)

Case Management Systems

Job description

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 1.2 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.

Under general supervision, obtains, locates, and processes resource requests and/or various types of referrals for
members seeking ongoing counseling services and/or work-life services, following clinical policy and procedure
guidelines. Maintains records of contacts with members, community resources/providers, and supervisors in
counseling case management system. Responds to routine to moderately complex inquiries from colleagues and
members. Recruits additional providers as needed and provides administrative and outreach support to clinical
department.

Responsibilities

• Reviews the work-life and/or counseling queue throughout the day to assist with prioritizing
  needs. Researches and contacts Counselors to facilitate case completion. Determines appropriate
  referral options for members and contacts providers for availability for referrals. Works with
  Counselors to secure resources, prioritize, and complete cases. Updates notes in counseling case
  management system to reflect inquiries and consultations on cases.


• Responds to and researches options for routine to complex provider requests via email, phone, or
  written correspondence. Verifies resources and referrals for each intake, provides provision of
  resources to the client, and follows up. Collaborates with leaders and colleagues regarding
  member needs.


• Updates and may create service provider profiles.


• Participates in onsite and phone meetings to suggest improvement ideas and provide support to
  clinical team.


• Recruits service providers to join the network as needed.


• Builds relationships with internal and external office personnel.


• As assigned, completes appointment reminder calls for scheduled counseling appointments in ESI
  offices.


• Performs other duties as assigned.

Qualifications

Qualifications

Education and Experience

• Associates Degree in Business or Healthcare Administration, Communications or a related field, or equivalent
  combination of education/training and experience.


• 3 years clinical operations support experience in behavioral healthcare or equivalent office experience supporting Counselors in a healthcare environment.

Technical Skills and Knowledge

• Knowledge of health insurance products and websites.


• Knowledge of HIPAA (Health Insurance Portability and Accountability Act) and Protected Health Information
  (PHI) regulations.


• Intermediate Microsoft Office (Word, Excel, Outlook) and database applications skills.


• Basic proficiency with case management systems.


• Solid data entry and keyboarding skills.


• Strong customer service and communication skills.


• Ability to organize and adapt to shifting priorities.

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.

Primary Location:US-Ohio

Other Locations:United States

Job:7 - General Staff

Organization:Employee Services, Inc

Schedule:Regular

Shift:Standard

Employee Status:Individual Contributor

Job Type:Full-time

Job Level:Day Job

Job Posting:Apr 7, 2025, 10:37:21 PM