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 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’re hired as an eligible colleague, you’ll be able to see how much you’ve 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 – 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 www.experiencecolumbus.com!

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 – all while making a real difference in patients’ lives – 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.