Assoc Specialist, Corp Credentialing (Remote)

Lensa; Detroit (MI); Remote; Full time

Job summary

A leading career site is seeking a Corporate Credentialing Associate Specialist for Molina Healthcare. This remote position involves processing credentialing applications, verifying necessary information, and ensuring compliance with regulatory standards. Ideal candidates will have strong critical thinking and communication skills, with a background in healthcare being a plus. Join a dynamic team to help maintain provider standards and maximize safety.

Qualifications

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

Responsibilities

• Evaluate credentialing applications for accuracy and completeness.
• Communicate with healthcare providers for clarifications.
• Update credentialing software with required data.

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)

Be among the first 25 applicants. Lensa, a leading career site, is seeking professionals for its client, Molina Healthcare. Apply today!

Molina Healthcare is hiring a Corporate Credentialing Associate Specialist. This remote role is available from 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, insurance, training, and certifications across 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; candidates with production or sales experience are encouraged to apply.
• Professionalism, excellent communication, and self-motivation

Job Summary

The Credentialing function ensures providers meet regulatory and risk management standards to minimize liability and maximize safety. Responsibilities include initial credentialing, recredentialing, and monitoring sanctions/exclusions, while maintaining confidentiality and meeting productivity goals.

Job Duties

• Evaluate credentialing applications for accuracy and completeness, obtaining necessary verifications.
• Communicate with healthcare providers for clarifications and missing information.
• Update credentialing software with required data.
• Request and follow up on recredentialing applications.
• Collaborate internally and externally to ensure timely processing.
• Make data corrections in the database as needed.
• Review claims systems and alerts for sanctions, exclusions, and Medicare opt-out status.
• Review NPDB reports and take appropriate actions.

Job Qualifications

Required Education: High School Diploma or GED.

Required Experience/Skills:

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

Preferred Experience: Healthcare industry experience.

Current Molina employees interested in this role should apply via the intranet. Molina offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $14.9 - $29.06 hourly, varies by location, experience, education, and skills.

Additional Details

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

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