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PAR - Case Manager II
Medical Mutual - Toledo, OH
The Case Manager II position allows you the flexibility to work at home as long as you reside within a 50-mile radius of the Toledo, OH Medical Mutual 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 1.6 million Ohioans through our high-quality health...
PAR - Provider Inquiry Representative I
Medical Mutual - Toledo, OH
This is a hybrid role and requires employees to be in our Toledo office 3 days a week. Investigates and resolves all inquiries (telephonic, written and faxed) from participating and non-participating hospitals, primary and specialty care physicians, ancillary and allied health care professionals regarding claim status, claim payment, authorization confirmations, facilitations...
PAR - Provider Credentialing & Data Specialist II
Medical Mutual - Toledo, OH
Under general supervision, performs typically routine to moderately complex initial and ongoing practitioner, provider, and organization data entry and credentialing into the various modules of the Provider Data Management System. Ensures compliance with standards set by individual states, federal and accrediting organizations and meets production and quality metrics. ESSENTIAL FUN...
PAR - Medical Coding Compliance Specialist
Medical Mutual - Toledo, OH
Job Summary: Optimizes/reviews documentation for the application of risk adjustment coding for ACA (Affordable Care Act) and MA (Medicare Advantage) with assigning and maintaining diagnoses medical codes. Evaluates requests for adherence to Company policies for the most precise medical codes. Audits vendors for quality assurance of risk adjustment coding f...
