Specialist, Provider Network Administration (Remote) @ Molina Healthcare | Jobright.ai
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Specialist, Provider Network Administration (Remote) jobs in Arizona, United States
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Molina Healthcare · 3 hours ago

Specialist, Provider Network Administration (Remote)

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Responsibilities

Oversees receipt of and coordinates data from the provider network for entry into the plan's provider management system.
Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.
Audits loaded provider records for quality and financial accuracy and provides documented feedback.
Assists in configuration issues with Corporate team members.
Assists in training current staff and new hires as necessary.
Conducts or participates in special projects as requested.

Qualification

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Managed Care ExperienceProvider Claims AdministrationClaims ProcessingMedical TerminologyCPT CodesICD-9 CodesAccessExcelProvider ServicesProvider Network OperationsHospital BillingPhysician BillingSubrogationEligibility Criteria

Required

Associate degree in Business or equivalent combination of education and experience
Min. 3 years managed care experience
Experience in one or more of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria.

Preferred

Bachelor's Degree
3+ years Provider Claims and/or Provider Network Administration experience
Experience in Medical Terminology, CPT, ICD-9 codes, etc.
Access and Excel – intermediate skill level (or higher)

Company

Molina Healthcare

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Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.

H1B Sponsorship

Molina Healthcare 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 (33)
2022 (36)
2021 (33)
2020 (60)

Funding

Current Stage
Public Company
Total Funding
$1.5B
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
2014-09-09Post Ipo Equity· $3.11M

Leadership Team

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Dave Reynolds
Executive Vice President, Regional Health Plans
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Debbie Simkins
Vice President, Office of the CIO
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Company data provided by crunchbase
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