Description
**Medical Mutual employees must submit their applications through MySource.
Note: This is a hybrid role requiring 3 days per week on-site in our Brooklyn, Ohio office. Seeking applicants that reside within a 50-mile radius of the Brooklyn, Ohio office.
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.
Performs the necessary intake and set-up of FMLA and ADA applications for the Specialty Group's book of business. Maintains leave administration system records of applications and files. Responds to emailed and faxed communications. Ability to use translation applications and forms.
Responsibilities
Leave Management Specialist I
- Performs initial intake of Family Medical Leaves (FML), Short-Term Disability (STD) and Life claims.
- Verifies eligibility of leaves.
- Initiates and maintains database of applications, within claims and leave administration systems.
- Manages the FML email box and dedicated phone lines. Responsible for language translation line and preparing non-English forms.
- Responsible for scanning of Short-Term Disability (STD) claim files for retention purposes.
- Responsible for maintaining FMLA compliance turnaround times.
- Performs other duties as assigned.
Leave Management Specialist II
- Interprets and administers leave programs and policies for assigned groups in accordance with applicable federal and state employment laws. Informs employees of eligibility status.
- Advises, counsels, and educates employees on leave policies, procedures, and programs.
- 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 (for specified groups) to ensure that leave processing is accurate.
- Produces and manages reporting metrics and analytics for all leave programs. Provides reports as requested.
- Researches and remains aware of changes of applicable laws (i.e.: FMLA, HIPAA, ADA, etc.).
- Performs other duties as assigned.
Qualifications:
Leave Management Specialist I
Education and Experience:
- Associate degree in Business Administration or any related field. Equivalent education and experience directly related to the role may substitute for a degree.
- 2 years of experience as a Leave Specialist or Absence Management administrator (FMLA, Short- or Long-Term Disability)
Professional Certification(s):
- Preferred: CLMS (Certified Leave Management Specialist) certification can be obtained within the first year of employment
Technical skills and Knowledge:
- Demonstrated knowledge of leave related rules and regulations including but not limited to FMLA, ADA, and HIPPA.
- Knowledge of Medical terminology.
- Proficiency in both oral and written communication.
- Detail oriented with the ability to remain organized and meet critical deadlines.
- Strong ability to manage multiple tasks.
- Ability to communicate effectively, both verbally and in writing.
- Ability to work in a fast-paced work environment.
- Excellent customer service skills.
Leave Management Specialist II
Education and Experience:
- Associate degree in business administration or any related field. Equivalent education and experience directly related to the role may substitute for a degree.
- 3 years of experience as a Leave Specialist or Absence Management Administrator (FMLA, Short- or Long-Term Disability)
Professional Certification(s):
- CLMS (Certified Leave Management Specialist) preferred, obtained within 6 months of employment. LOMA (preferred).
- ALHC (Associate, Life and Health Claims) (preferred).
Technical Skills and Knowledge:
- Demonstrated knowledge of leave related federal and state regulations including but not limited to FMLA, ADA and HIPAA.
- Ability to establish and maintain contact with internal and external customers, consultants, attorneys, and vendors.
- Demonstrated ability to deal with confidential information.
- Proficient in the use of word processing, spreadsheet, presentation and database software.
- Ability to communicate effectively, both verbally and in writing.
- Detail oriented with the ability to remain organized and meet critical deadlines.
- Ability to work in a fast-paced work environment.
- Excellent customer service skills.
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.
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