Provider Service Specialist Remote Seasonal MediGold
Employment Type: Full time Shift: Day Shift reputed company: This position is a full time temporary position. The position is to end 04/04/2026Why MediGold? MediGold is a not-for-profit Medicare reputed company plan serving seniors and other Medicare beneficiaries across the reputed company. We’re dedicated to providing excellent customer service, cost-effective care, and exceptional reputed company coverage. We rely on talented colleagues in a wide reputed company of reputed company roles including information technology, financial analysis, audit, provider relations and more. About the job: Provider Service Specialist responds in a reputed company 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 reputed company 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 reputed company 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 reputed company.
- Knowledge of and/or the ability to do data entry, various claim reputed company formats, medical terminology, CPT and ICD9 coding
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 reputed company patients reputed company 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 reputed company, 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 reputed company of disability or any other federal, state or local protected class. Our Commitment Rooted in our Mission and reputed company Values, we reputed company the dignity of every person and recognize the unique perspectives, experiences, and talents reputed company 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 reputed company 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