Assoc Specialist, Corp Credentialing (Remote)

Lensa; Savannah (GA); Remote; Full time

Job summary

A leading healthcare company is seeking a Corporate Credentialing Associate Specialist to process credentialing applications. This remote role involves verifying licensure and ensuring compliance with regulatory standards. Ideal candidates will possess strong critical thinking and communication skills, with a background in healthcare preferred but not required.

Qualifications

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

Responsibilities

• Evaluate credentialing applications for accuracy and completeness.
• Communicate with healthcare providers for clarification and missing information.
• Update credentialing software systems.

Skills

Critical Thinking

Time Management

Self-Motivation

Communication

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 wanting 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
• Ability to work independently with good time management
• Self-motivated and 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 providers meet 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 role also involves meeting daily/weekly production goals and maintaining confidentiality.

Job Duties

• Evaluate credentialing applications for accuracy and completeness, obtain verifications, and meet production goals
• Communicate with healthcare providers for clarification and missing information
• Update credentialing software systems
• Request and follow up on recredentialing applications
• Collaborate internally and externally to ensure timely processing
• Make data corrections in the credentialing database
• Review claims payment systems for provider status as needed
• Follow up on ‘watch’ status provider files
• Process alerts for sanctions, exclusions, Medicare opt-outs, and NPDB reports

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 systems
• Strong written and verbal communication skills

Preferred Experience: Healthcare industry experience

Current Molina employees interested in this role 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: $14.9 - $29.06/hour. Actual compensation may vary based on location, experience, education, and skills.