Molina Healthcare · 6 hours ago

Assoc Specialist, Provider Network Admin

Texas, United States

Full-time

Remote

Entry Level

$13.55/hr - $26.42/hr

1+ years exp

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Responsibilities

Receives information from outside parties for update of provider-related information in computer system(s).

Coordinates preparation and routing distribution of documents to complete the contracting/credentialing process in a timely and thorough manner according to standardized process.

Reviews/analyzes contracts and amendments, including but not limited to fee for Service and Alternative Payment Methods including Pay for Performance.

Understanding credentialing requirements and regulations.

Reviews/analyzes data by applying job knowledge to ensure appropriate information has been provided.

Maintains department quality standards for provider demographic data with affiliation and fee schedule attachment.

Ensures accurate entries of information into health plan systems.

Works on projects as assigned and within parameters given.

Conducts or participates in special projects as requested.

Qualification

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Managed Care ExperienceProvider Network AdministrationProvider ClaimsHospital BillingPhysician BillingData AnalysisCredentialing RequirementsMicrosoft ExcelMicrosoft OutlookMicrosoft WordContract ReviewInternet Research