Assoc Specialist, Corp Credentialing (Remote)

Lensa; Covington (KY); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading career site is seeking a Corporate Credentialing Associate Specialist for Molina Healthcare. This remote role involves processing credentialing applications and ensuring compliance with regulatory standards. Ideal candidates will possess strong critical thinking and communication skills, with a background in healthcare preferred. Join a dynamic team committed to excellence in provider credentialing.

Qualifications

• Experience in a production or administrative role requiring self-direction and critical thinking.
• Healthcare industry experience preferred.

Responsibilities

• Evaluate credentialing applications for accuracy and completeness.
• Communicate with healthcare providers to clarify questions.
• Process daily alerts for sanctions and exclusions.

Skills

Critical Thinking

Time Management

Communication

Self-Motivation

Education

High School Diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Job description

Assoc Specialist, Corp Credentialing (Remote)

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Molina Healthcare is hiring for a Corporate Credentialing Associate Specialist. This role is remote and can be worked from various locations within the US.

This position processes credentialing and recredentialing applications for practitioners and facilities wishing to join the Molina Healthcare network. Responsibilities include verifying licensure, DEA, work history, professional liability insurance, training, board certification, etc. We support all lines of business.

Highly qualified candidates will have the following experience:

• Excellent critical thinking skills
• Ability to work independently with good time management
• Self-motivated and driven
• Healthcare or credentialing background is helpful but not required; applicants with experience in production-based or sales roles are encouraged to apply
• Professionalism, excellent communication skills, and self-motivation

Job Summary

Molina's Credentialing function ensures providers meet all regulatory and risk management criteria, minimizing liability and maximizing safety. This role involves initial credentialing, recredentialing, and ongoing monitoring of sanctions and exclusions for practitioners and healthcare organizations, adhering to Molina policies and procedures. The position requires meeting daily/weekly production goals and maintaining confidentiality of provider information.

Job Duties

• Evaluate credentialing applications for accuracy and completeness, obtain necessary verifications, and meet production goals
• Communicate with healthcare providers to clarify questions and request missing information
• Update credentialing software systems with required data
• Request and follow up on recredentialing applications
• Collaborate with internal and external contacts for timely processing
• Make data corrections in the credentialing database as needed
• Review claims payment systems to determine provider status
• Follow up on ‘watch’ status provider files
• Process daily alerts for sanctions, exclusions, Medicare opt-outs, and NPDB reports, taking appropriate actions

Job Qualifications

Required Education: High School Diploma or GED

Required Experience/Skills:

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

Preferred Experience: Healthcare industry experience

If you are a current Molina employee interested in this position, please apply through the intranet.

Molina Healthcare offers competitive benefits and compensation. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $14.90 - $29.06 hourly. Actual compensation may vary based on location, experience, education, and skills.