Assoc Specialist, Corp Credentialing (Remote)

Lensa; Sterling Heights (MI); 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. Ideal candidates will possess strong critical thinking and communication skills, with a background in healthcare 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

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

Skills

Critical Thinking

Time Management

Professional Communication

Self-Motivation

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

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 seeking 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.

Highly Qualified Candidates Will Have the Following Experience

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

Job Summary

Molina's Credentialing function ensures 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, following Molina policies and procedures. The position also requires meeting daily/weekly production goals and maintaining confidentiality of provider information.

Job Duties

• Evaluate credentialing applications for accuracy and completeness, obtain required verifications, and meet production goals.
• Communicate with healthcare providers to clarify questions and request missing information.
• Update credentialing software systems with required information.
• Request recredentialing applications and follow up accordingly.
• Collaborate with internal and external contacts for timely processing.
• Make data corrections in the credentialing database as needed.
• Review claims payment systems to determine provider status.
• Follow up on ‘watch’ status provider files.
• Process 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 and Word, and other software.
• Professional written and verbal communication skills.

Preferred Experience

Experience in the healthcare industry.

Interested internal candidates should apply through the intranet.

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

Additional Details

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

Additional Information

• Seniority Level: Entry level
• Employment Type: Full-time
• Job Function: Other
• Industries: IT Services and IT Consulting

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