Senior Business Systems Specialist

Note:

This role is fully remote with a strong preference for candidates living in the US Central or Eastern Time Zone.

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.

Job Summary

Works with management, external vendors, and Information Systems to define, develop, test, and implement new operations business systems (e.g., Claims, Membership, Billing, Customer Care) and processes of increased complexity and size. Serves as a project leader to identify dependencies, constraints, and resources. Communicates system changes to users and Training. Provides coordination and technical guidance to internal and external team members.

Responsibilities

• Acts as a project leader in the development and testing of major system modifications. Acts as a consultant to other departments regarding the impact of system changes.
• Analyzes, evaluates and/or recommends business requirements for new or enhanced systems. Works with Information System Development (ISD) to ensure system integrity.
• Analyzes systems issues to determine system or procedural problems. Researches recreate and monitors reported issues using procedural and technical system documentation.
• Provide technical and testing guidance to more junior staff in support of major system troubleshooting, system modifications and documentation.
• Performs other duties as assigned.

Qualifications

Education and Experience

• Bachelor’s degree in business administration or related field or equivalent combination of education and experience.
• 5 years progressive experience as a Business Systems Specialist or equivalent experience with software quality assurance and testing processing systems in multiple operational departments.

Professional Certification(s)

• Project Management Certification preferred.

Technical Skills and Knowledge

• Comprehensive knowledge of Project Management methodologies.
• Comprehensive knowledge of claims adjudication systems and processes and contract/regulation language.
• Strong project management skills; ability to handle multiple, concurrent projects under tight deadlines.
• Demonstrated proficiency in research techniques and system analysis.
• Advanced Microsoft Office skills.
• Advanced proficiency with Power BI, Tableau, SQL tools preferred.

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.
• 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.

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…