Assoc Specialist, Corp Credentialing (Remote)

Lensa; Mesa (AZ); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking a Corporate Credentialing Associate Specialist to process credentialing applications for practitioners. This remote role involves verifying licensure and ensuring compliance with regulatory standards. Candidates should have strong communication skills and critical thinking abilities. Experience in healthcare is preferred but not required.

Qualifications

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

Responsibilities

• Evaluating credentialing applications for accuracy and completeness.
• Communicating with healthcare providers to clarify questions.
• Updating 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)

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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 and driven
• Healthcare or credentialing background is helpful but not required. Candidates with experience in production-based or sales roles are encouraged to apply.
• Professional demeanor, excellent communication skills, and self-motivation

Job Summary:

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

Job Duties:

• Evaluating credentialing applications for accuracy and completeness, obtaining required verifications as per policies and regulations, while meeting production targets.
• Communicating with healthcare providers to clarify questions and request missing information.
• Updating credentialing software with required data.
• Requesting and following up on recredentialing applications, collaborating with internal and external contacts for timely processing.
• Making data corrections in the credentialing database as needed.
• Reviewing claims payment systems to verify provider status.
• Following up on provider files flagged for sanctions or exclusions.
• Processing 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 and Word, and other software.
• Strong professional written and verbal communication skills.

Preferred Experience: Healthcare industry experience.

Internal applicants should apply through the intranet. Molina offers competitive benefits. Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $14.90 - $29.06/hour. 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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