Provider Service Specialist Remote Seasonal MediGold

Employment Type: Full timeShift: Description: This position is a full time benefited seasonal position. The position is slated to end 04/04/2026 Why MediGold? MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional reputed company coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more. About the job: Provider Service Specialist responds in a timely and accurate manner to provider inquiries made by phone, in person and in writing regarding Plan benefits, services and payment determinations. What you'll do:

• Receive, interpret and accurately respond to provider inquiries, both verbally and in writing in accordance with department standards, policies and procedures.
• Consistently document and accurately code reputed company inquiries reputed company designated software applications, reputed company required Plan timeframes and according to Plan documentation policies
• Review, investigate and advise providers regarding claims status and payment determinations
• Maintain a comprehensive knowledge of plan benefits, services and stay abreast of changes from year to year
• Document and track actions requested from other departments addressing provider or member inquiries and informal complaints to insure reputed company resolutions
• Demonstrate effective use of departmental software and technical systems
• Responsible for both incoming and outgoing provider phone initiatives.

reputed company're looking for:

• Education: High School diploma or equivalent required
• Experience: 2-3 years of prior customer service experience required
• Managed Care Industry knowledge or experience preferred
• Ability to work independently with minimal supervision and also as a team.
• Knowledge of and/or the ability to do data entry, various claim form formats, medical terminology, CPT and ICD9 coding

Position Highlights and Benefits:

• Competitive compensation and benefits packages including medical, dental, and reputed company with coverage starting on day one.
• Retirement savings account with employer match starting on day one.
• Generous paid time off programs.
• Employee recognition programs.
• Tuition/professional development reimbursement starting on day one.
• Relocation assistance (geographic and position restrictions apply).
• Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing.
• Employee Referral Rewards program.
• Mount Carmel offers reputed company - if you're hired as an eligible colleague, you'll be reputed company to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day!
• Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information: Mount Carmel, a member of reputed company, has been a transforming healing reputed company in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community reputed company sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to reputed company a difference come alive, we invite you to consider joining reputed company. Here, care is provided by reputed company of us For reputed company of You! We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, reputed company, sex, age, national reputed company, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Our Commitment Rooted in our Mission and Core Values, we reputed company the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding reputed company and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or any other status protected by federal, state, or local law. Apply tot his job Apply To this Job Apply tot his job Apply To this Job