Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
• Responsible for the team achieving or exceeding performance metric targets
• Act as liaison with health plans for Provider Information function regarding workflow and submission of required documentation.
• Appropriately identify issues pertaining to Provider data and document necessary re-work that may be required.
• Conduct and document operational meetings with health plans, on a weekly basis.
• Responsible for developing and coaching the team for professional growth.
Associate's Degree or equivalent combination of education and experience
3-5 years in healthcare (credentialing, claims, provider networks, provider configuration)
QNXT or Facets experience
Bachelor's Degree or equivalent combination of education and experience
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Apply on company website