Assoc Specialist, Corp Credentialing - Remote

Lensa; Dallas (TX); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading career site is seeking an Associate Specialist for Corporate Credentialing, focusing on initial credentialing and ongoing monitoring for healthcare providers. The role requires strong communication skills and proficiency in various software systems. Ideal for entry-level candidates with a high school diploma or GED. Competitive pay and benefits are offered.

Qualifications

• Experience in a production or administrative role.
• Proficiency with computers and internet research.

Responsibilities

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

Skills

Self-Direction

Critical Thinking

Professional 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 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!

Job Description

Job Summary

Molina's Credentialing function ensures that the provider network meets all regulatory and risk management criteria to minimize liability and maximize safety for members. This position handles initial credentialing, recredentialing, and ongoing monitoring of sanctions and exclusions for practitioners and healthcare organizations, following Molina policies and procedures. The role also involves meeting daily/weekly production goals and maintaining confidentiality of provider information.

Job Duties

• Evaluate credentialing applications for accuracy and completeness, obtain required 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, ensuring timely processing.
• Collaborate with internal and external contacts to process applications efficiently.
• Make data corrections in the credentialing database as needed.
• Review claims payment systems for provider status, as necessary.
• Follow up on ‘watch’ status provider files according to guidelines and goals.
• Process daily alerts for sanctions, exclusions, Medicare opt-out, and NPDB reports, taking appropriate action.

Job Qualifications

Required Education: High School Diploma or GED.

Required Experience/Knowledge Skills & Abilities:

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

Preferred Experience: Experience in the healthcare industry.

Current Molina employees interested in this position should apply through the intranet.

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

Pay Range: $21.16 - $34.88/hour. Actual compensation may vary based on location, experience, education, and skills.

Additional Information

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

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