Assoc Specialist, Corp Credentialing (Remote)

Lensa; Houston (TX); Remote; Full time

Job summary

A leading company is seeking a Corporate Credentialing Associate Specialist to manage credentialing applications for healthcare providers. This remote role requires critical thinking and excellent communication skills, ensuring compliance with regulatory standards while meeting production goals. Candidates with a background in healthcare or administrative roles are encouraged to apply. Competitive pay and benefits offered.

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 and request missing information.
• Process daily alerts for sanctions and exclusions.

Skills

Critical Thinking

Time Management

Professionalism

Communication

Education

High School Diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Job description

Assoc Specialist, Corp Credentialing (Remote)

2 days ago - Be among the first 25 applicants

Get AI-powered advice on this job and more exclusive features.

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, and board certification. We support all Lines of Business (LOBs).

Highly Qualified Candidates Will Have the Following Experience:

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

Job Summary

Molina's Credentialing function ensures that the provider network meets all regulatory and risk management criteria to minimize liability and maximize safety. This role involves initial credentialing, recredentialing, and ongoing monitoring of sanctions and exclusions for practitioners and 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, obtaining required verifications per policies and regulations, while meeting production targets.
• Communicate with healthcare providers to clarify questions and request missing information.
• Update credentialing software systems with necessary information.
• Request recredentialing applications from providers and follow up accordingly.
• Collaborate with internal and external contacts to ensure timely processing or termination of applications.
• Make data corrections in the credentialing database as needed.
• Review claims payment systems to confirm provider status.
• Follow up on ‘watch’ status files as necessary.
• 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.
• Professional written and verbal communication skills.

Preferred Experience: Healthcare industry experience is a plus.

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: $14.90 - $29.06/hour, with actual pay depending on location, experience, education, and skills.

Additional Details

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

Referrals can double your chances of interviewing at Lensa.

Get notified about new Associate Specialist jobs in Houston, TX.

We’re enhancing community knowledge with insights directly added into articles, starting with AI assistance.