Provider Service Specialist Remote Seasonal MediGold
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Job Location:
Columbus, NE - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Employment Type:
Full timeShift:
Day ShiftDescription:
This position is a full time temporary position. The position is to end 04/04/2026Why MediGold
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 youll 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 all inquiries within designated software applications within 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 prompt resolutions
- Demonstrate effective use of departmental software and technical systems
- Responsible for both incoming and outgoing provider phone initiatives.
What were 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
Ministry/Facility Information:
Mount Carmel a member of Trinity Health has been a transforming healing presence 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 outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohios largest undergraduate graduate and doctor of nursing programs. If youre seeking a rewarding career where your purpose passion and desire to make a difference come alive we invite you to consider joining our team. Here care is provided by all of us For All of You!
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race color sex age national origin 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 honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity ... View more
