Temporary Reconciliation Analyst - MediGold Premium Billing

Trinity Health•Columbus, OH

21h•Onsite

About The Position

This is a full-time, temporary role through July 2026 for a Reconciliation Analyst at MediGold. The 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, as well as accurate billing and premium payment reconciliation of the plan's membership. This role also organizes, conducts, and monitors the special status tracking process to ensure accurate reporting and payment from CMS for enrollees in a special payment status category. The position is responsible for all eligibility and membership functions relating to enrollment, disenrollment, special status, billing, premiums, revenue, and reconciliation processes for the health plan in accordance with Federal regulatory requirements and the Centers for Medicare and Medicaid Services (CMS). The analyst ensures the accuracy of eligibility, demographic data, billing, and revenue for membership. They organize, conduct, and monitor enrollment and billing processes to ensure accurate and timely transactions and revenue from CMS and members.

Requirements

Managed care insurance industry experience required.
Able to apply regulations to work processes.
Proven ability to successfully work with internal and external groups to accomplish reconciliation of payment reports and activities.
Proven skill and ability to track and report financial and statistical data.
Knowledge of computer systems including Microsoft Office.
Service-oriented individual with an ability to effectively resolve customer issues.
Analytical and problem solving skills.

Nice To Haves

Associates degree in business or related field preferred or equivalent experience required.

Responsibilities

Assures provision of timely and accurate enrollment information (letters, certificates, Member Agreement, handbooks, ID cards, etc.) to members, 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 to ensure accuracy and meet Federal requirements.
Maintains current knowledge of CMS regulations related to enrollment, disenrollment, billing, and special statuses.
Compile information and documentation to support special status payment requests to governmental agencies.
Respond to written and verbal requests for information from federal and local Government agencies such as CMS, or state department of insurance.
Monitors and effectuates membership and financial transactions including payment posting, reconciliation, electronic funds transfer posting and maintenance, late letter process, processing of returned payments, billing statements, evaluation and completion of required reporting.
Willingness to learn and comprehend various aspects of Plan and identify engagement opportunities and integration points.

Benefits

Medical insurance
Dental insurance
Vision insurance
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
RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing
Relocation assistance (geographic and position restrictions apply)
Employee Referral Rewards program
DailyPay - ability to see earnings daily and transfer money any time before payday
Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups