Senior Business Systems Specialist: Claims & Care

Medical Mutual Of Ohio

Phoenix (site) (AK)

On-site

USD 70,000 - 105,000

Full time

14 days+

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Benefits offered by this job

On-site fitness centers

Gym membership reimbursement

On-site cafeteria

Employee discounts

Cash rewards program

Business casual attire

Job summary

Medical Mutual Of Ohio in Brooklyn, OH is seeking a Business Systems Specialist to define, develop, test and implement new business systems and processes affecting claims and customer care. You will collaborate with management, external vendors and Information Systems to ensure changes meet requirements and positively impact operations.

This role emphasizes diagnosing production issues, coordinating testing efforts, and guiding junior staff, with opportunities across Specialist I–Senior levels

Qualifications

Bachelor's degree in Business Administration or related field or equivalent experience.
Experience with healthcare claims processing systems and QA/testing.
Strong analytical and problem-solving abilities.
Knowledge of claims adjudication systems and contract language is beneficial.

Responsibilities

Define, develop, test, audit and implement business systems and processes.
Identify and solve production issues requiring system changes.
Communicate system changes to users and Training.
Lead or co-lead testing of system modifications.

Skills

Analytical thinking

Problem solving

Communication skills

Team collaboration

Education

Bachelor's Degree in Business Administration or related field

Tools

Power BI

Tableau

SQL

Microsoft Office

Job description

This role emphasizes diagnosing production issues, coordinating testing efforts, and guiding junior staff, with opportunities across Specialist I–Senior levels

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