What are the responsibilities and job description for the Superior Dental Care-Claims/Customer Care Specialist position at Medical Mutual?
This position offers a hybrid or remote work option. Note, quarterly on-site requirement in Centerville, 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 1.6 million Ohioans 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.
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 and help our members achieve their best possible health and quality of life.
Responsibilities
SDC – Claims/Customer Care Specialist I
In this blended role, processes routine claims, while handling inbound calls from members, providers, clients, employers, and brokers, in accordance with established performance expectations, service philosophy, and service level agreements.
In this blended role, processes routine to moderately complex claims, while handling inbound calls and written inquiries (multiple channels) from members, providers, clients, employers, and brokers, in accordance with established performance expectations, service philosophy, and service level agreements.
SDC – Claims/Customer Care Specialist I
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:
Superior Dental Care (SDC) leads the way in dental benefits through superior service, advanced technology, and efficient operation. SDC was founded on the belief of treating people with respect, care and concern, and this approach begins with our own employees. Each employee at SDC feels the value of their role in the company's success. Through a shared commitment to promoting the affordable and quality dental care that everyone deserves, staff work together seamlessly to keep SDC's members, clients, dentists and brokers smiling. Come join a truly superior team!
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
Primary Location
US-OH-Centerville
Work Locations
Centerville
Job
7 - General Staff
Organization
SDC-Dental Services
Schedule
Regular
Shift
Standard
Employee Status
Individual Contributor
Job Type
Full-time
Job Level
Day Job
Job Posting
Mar 12, 2025, 1:39:42 PM
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 1.6 million Ohioans 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.
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 and help our members achieve their best possible health and quality of life.
Responsibilities
SDC – Claims/Customer Care Specialist I
In this blended role, processes routine claims, while handling inbound calls from members, providers, clients, employers, and brokers, in accordance with established performance expectations, service philosophy, and service level agreements.
- Utilizing multiple systems, applications, and reference tools, processes routine claims, while providing customer service via inbound call queues.
- Performs other duties as assigned.
In this blended role, processes routine to moderately complex claims, while handling inbound calls and written inquiries (multiple channels) from members, providers, clients, employers, and brokers, in accordance with established performance expectations, service philosophy, and service level agreements.
- Utilizing multiple systems, applications, and reference tools, processes routine to moderately complex claims and adjustments, while providing customer service via inbound call queues and various channels of written communications (such as email, chat, and portal inquiries).
- Under direction of more senior staff, conducts claims or inquiry related research.
- Assists with projects as directed by management.
- Performs other duties as assigned.
SDC – Claims/Customer Care Specialist I
- Associate degree in business or healthcare administration, communications or related field or equivalent combination of training and experience.
- 1 year customer service and/or claims experience, preferably in a call center in the health or dental insurance industry or dental providers office.
- Certified Dental Billing Specialist (CDBS), Certified Dental Coder (CDC), or Certified Dental Assistant (CDA) a plus.
- Basic Microsoft Office skills.
- Basic knowledge of dental benefits, services, terminology, and American Dental Association coding.
- Knowledge of standard customer services best practices and principles.
- Knowledge of Heath Insurance Portability and Accountability Act (HIPAA).
- Associate degree in business or healthcare administration, communications or related field or equivalent combination of training and experience.
- 2 years of experience as a Claims/Customer Care Specialist or equivalent customer service experience, preferably in dental insurance, dental providers office, or the healthcare/health insurance industry.
- Certified Dental Billing Specialist (CDBS), Certified Dental Coder (CDC), or Certified Dental Assistant (CDA) a plus.
- Basic to intermediate Microsoft Office skills.
- Solid knowledge of dental benefits, services, terminology, and American Dental Association coding.
- Knowledge of standard customer services best practices and principles.
- Knowledge of Heath Insurance Portability and Accountability Act (HIPAA).
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:
- 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.
- 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.
- 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.
Superior Dental Care (SDC) leads the way in dental benefits through superior service, advanced technology, and efficient operation. SDC was founded on the belief of treating people with respect, care and concern, and this approach begins with our own employees. Each employee at SDC feels the value of their role in the company's success. Through a shared commitment to promoting the affordable and quality dental care that everyone deserves, staff work together seamlessly to keep SDC's members, clients, dentists and brokers smiling. Come join a truly superior team!
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
Primary Location
US-OH-Centerville
Work Locations
Centerville
Job
7 - General Staff
Organization
SDC-Dental Services
Schedule
Regular
Shift
Standard
Employee Status
Individual Contributor
Job Type
Full-time
Job Level
Day Job
Job Posting
Mar 12, 2025, 1:39:42 PM
Salary : $5,250
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