Assoc Specialist, Corp Credentialing (Remote)

Lensa; Fort Worth (TX); 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, verifying information, and ensuring compliance with regulations. Candidates should possess critical thinking skills and a high school diploma. Experience in healthcare is preferred but not required.

Benefits

Competitive Benefits

Qualifications

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

Responsibilities

• Evaluate credentialing applications for accuracy and completeness.
• Communicate with healthcare providers to clarify questions.
• Update credentialing software systems with required data.

Skills

Critical Thinking

Time Management

Communication

Education

High School Diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Job description

Assoc Specialist, Corp Credentialing (Remote)

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Lensa, a leading career site, connects job seekers at every career stage. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

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

This position involves processing credentialing and recredentialing applications for practitioners and facilities wishing to join the Molina Healthcare network. Responsibilities include verifying licensure, DEA, work history, insurance, training, and certifications. The role supports all lines of business.

Highly Qualified Candidates Will Have the Following Experience

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

Job Summary

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

Job Duties

• Evaluate credentialing applications for accuracy and completeness, obtain verifications per policies/regulations, and meet production targets.
• 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 internally and externally to ensure timely processing.
• Make necessary data corrections in the credentialing database.
• Review claims payment systems for provider status.
• Follow up on ‘watch’ status files and alerts for sanctions, exclusions, Medicare opt-out, 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.
• Professional written and verbal communication skills.

Preferred Experience: Healthcare industry experience.

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

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

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

Additional Details

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

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