Job Description

Employment Type: Full time

Shift:

Description:

Why MediGold?

is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We\xe2\x80\x99re dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.

We know that exceptional patient care starts with taking care of our colleagues, so we invest in great people and all that we ask in return is that you come to work ready to make a difference and do the right thing.

What we offer:

Competitive compensation and benefits packages including medical, dental, and vision coverage

Retirement savings account with employer match starting on day one

Generous paid time off programs

Employee recognition incentive program

Tuition/professional development reimbursement

Relocation assistance (geographic restrictions apply)

Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing

Mount Carmel offers DailyPay - if you\xe2\x80\x99re hired as an eligible colleague, you\xe2\x80\x99ll be able to see how much you\xe2\x80\x99ve made every day and transfer your money any time before payday. You deserve to get paid every day!

Why Columbus?

The nation\'s 14th largest city, Columbus, Ohio is one of the fastest growing major metropolitan areas in the Midwest \xe2\x80\x93 ranked #1 for population growth, #1 for job growth, #1 for wage growth, and #1 real estate market. And with a vibrant blend of professional sports, world-class attractions, creative cuisines, and a flourishing music and arts scene, you\'ll never be found wanting for entertainment and experiences to call your own in Columbus. Learn more at !

About the job:

Our Reconciliation Analyst plans, organizes, conducts and monitors the enrollment and reconciliation process to ensure accurate membership processing, application and reconciliation of all data and payments from CMS. Organizes, conducts and monitors the special status tracking process to ensure accurate reporting and payment from CMS for enrollees who fall into a special payment status category. Organizes, conducts and reconciles the risk score assignment of enrolled beneficiaries to ensure accurate payment and reporting.

Responsibilities

Reviews and processes election forms, including all required data elements, and establishes group and member enrollment records, in accordance with department standards, policies and procedures.

Reconciles the CMS transaction reply reports against the membership files of the health plan in accordance with department standards, policies and procedures. Contacts applicants to obtain missing or clarifying information related to enrollment and eligibility. Provides customer service for member-specific issues.

Maintains current knowledge of CMS regulations related to enrollment, disenrollment and special statuses.

Requirements/Qualifications

Education: Associates degree in business or related field, or equivalent experience

Experience: Managed care insurance industry experience required

Effective Communication Skills. Ability to effectively conduct and monitor multiple procedures simultaneously. Ability to work in multiple computer programs simultaneously. Detail oriented with demonstrated ability to enter data accurately.

Proven ability to successfully work with internal and external groups to accomplish reconciliation of payment reports and activities.

Discovering opportunities, support and excellence \xe2\x80\x93 all while making a real difference in patients\xe2\x80\x99 lives \xe2\x80\x93 begins at Mount Carmel. Find a new beginning and advance your career with us.

Mount Carmel and all its affiliates are proud to be equal opportunity employers. We do not discriminate on the basis of race, gender, religion, or physical ability.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

Trinity Health