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Company

Trinity Health · 4 hours ago

Operations Resolution Specialist - Provider Data Management MediGold- Remote

Columbus, OH

Full-time

Remote

Entry, Mid Level

1+ years exp

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DeliveryHealth Care

H1B Sponsor Likely

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Responsibilities

Responds to sensitive, escalated and difficult inquiries. Researches, resolves and responds to such inquiries in a timely, compliant and courteous manner.

Determines trends and provides education and feedback related to escalated questions and issues.

Coordinates the identification of root causes for errors and works with multiple operational areas across the Plan to fully resolve identified errors.

Generates reports as necessary to monitor processes.

Assists in the development and maintenance of department policies and procedures.

Functions as a team member by serving as a department resource and subject matter expert

Assists in the development of tools and presentations on documentation, coding, billing, and other requirements necessary for complete encounter data submissions

Works proactively with external vendors to troubleshoot encounter errors and correction of necessary inbound data

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

CPC certificationInsurance LicenseManaged care experienceCustomer service experienceProvider coding knowledgeHealthcare claims processMedical terminologyAnatomy knowledgePhysiology knowledgeProvider credentialing knowledgeContracting terminology

Required

CPC, CPC-P or equivalent required for Claims department.

Active State of Ohio Insurance License (Life and Health) or obtained within 90 days of hire for Member Services department.

Knowledgeable in provider coding and billing requirements.

Knowledgeable with provider credentialing and contracting terminology.

Basic knowledge of the healthcare claims process.

General knowledge of current medical terminology, anatomy and physiology.

Preferred

Associate or Bachelor's degree preferred.

One to three years experience preferred in either managed care health insurance, or customer service disciplines.

Benefits

Medical, dental, and vision 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

Relocation assistance (geographic and position restrictions apply)

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

Employee Referral Rewards program

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.

Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Company

Trinity Health

Glassdoor

3.4

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation.

Founded in 1978

Livonia, Michigan, USA

10001+ employees

http://www.trinity-health.org

H1B Sponsorship

Trinity Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (6)

2022 (11)

2021 (7)

2020 (10)