Assoc Specialist, Corp Credentialing (Remote)

Lensa; Cincinnati (OH); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading career site is assisting in hiring a Corporate Credentialing Associate Specialist for Molina Healthcare. This remote role involves processing credentialing applications, ensuring compliance with regulatory standards, and maintaining confidentiality. Ideal candidates should possess strong critical thinking and communication skills, with a background in healthcare preferred.

Qualifications

• Experience in production or administrative roles requiring critical thinking and self-direction.
• Proficiency with computers and internet research.

Responsibilities

• Evaluate applications for accuracy and completeness.
• Communicate with providers to clarify missing information.
• Monitor sanctions, exclusions, and provider status.

Skills

Critical Thinking

Time Management

Self-Motivation

Communication

Education

High School Diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Job description

Assoc Specialist, Corp Credentialing (Remote)

Be among the first 25 applicants. Lensa, a leading career site, is assisting Molina Healthcare in hiring for a Corporate Credentialing Associate Specialist. This remote role is open to various locations within the US.

This position involves processing credentialing and recredentialing applications for practitioners and facilities seeking to join the Molina Healthcare network. Responsibilities include verifying licensure, DEA, work history, professional liability insurance, training, and board certification, supporting all lines of business.

Ideal candidates will have:

• Excellent critical thinking skills
• Ability to work independently with good time management
• Self-motivation and drive
• Healthcare or credentialing experience is helpful but not required; experience in production or sales roles is encouraged
• Professionalism, strong communication skills, and self-motivation

Job Summary: Ensures the provider network meets regulatory and risk management standards, minimizes liability, and maximizes member safety. Responsible for initial credentialing, recredentialing, and monitoring sanctions/exclusions, meeting daily/weekly production goals while maintaining confidentiality.

Key Responsibilities:

• Evaluate applications for accuracy, completeness, and verifications per policies and regulations
• Communicate with providers to clarify or obtain missing information
• Update credentialing systems
• Request and follow-up on recredentialing applications
• Coordinate with internal/external contacts for timely processing
• Perform data corrections and review claims systems for provider status
• Monitor 'watch' status, sanctions, exclusions, Medicare opt-out, and NPDB reports, taking appropriate actions

Qualifications:

• High School Diploma or GED
• Experience in production or administrative roles requiring critical thinking and self-direction
• Proficiency with computers, internet research, Microsoft Outlook and Word, and other software
• Strong written and verbal communication skills

Preferred: Healthcare industry experience

Interested internal candidates should apply via the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay range: $14.90 - $29.06 hourly, varies by location, experience, and skills.

Additional Details:

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Other
• Industry: IT Services and Consulting