Molina Healthcare
Senior Specialist, Provider Network Administration (Remote)
NewWhat's your preference?
Job Description
- Req#: 2036009
Employer Industry: Healthcare Provider Network Administration
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive benefits and compensation package
- Supportive and collaborative work environment
- Chance to make a positive impact on provider network efficiency and quality
- Involvement in continuous quality improvement initiatives
What to Expect (Job Responsibilities):
- Generate and prepare provider-related data and reports, ensuring accuracy in computer systems
- Provide timely generation and distribution of reports supporting compliance and operational needs
- Review and analyze data to ensure appropriate information is provided
- Audit provider records for quality and financial accuracy, offering documented feedback
- Assist in resolving configuration issues and support provider network administration projects
What is Required (Qualifications):
- At least 4 years of healthcare experience, including claims, provider services, or hospital/physician billing
- Claims processing experience, including coordination of benefits and eligibility criteria
- Proficiency in medical terminology, CPT, and ICD-9/ICD-10 codes
- Strong attention to detail and ability to facilitate accurate data entry/review
- Effective verbal and written communication skills and proficiency in Microsoft Office suite
How to Stand Out (Preferred Qualifications):
- Experience with query language
#Healthcare #ProviderNetwork #DataManagement #HealthcareCareers #QualityImprovement
We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Molina Healthcare is a managed care company headquartered in Long Beach, California, United States.
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.