Associate Specialist, Provider Network Administrator

Molina Healthcare; Long Beach (CA); Remote; USD 45,000 - 65,000; Full time

Job summary

Molina Healthcare is seeking a Provider Network Administration professional in California, responsible for managing provider information and ensuring compliance with business standards. Candidates should have a high school diploma and at least one year of experience in managed care. This remote position offers an opportunity to work in a dynamic healthcare environment.

Qualifications

• Minimum 1 year of managed care experience required.
• Experience in Claims, Provider Services, or billing preferred.
• 2+ years managed care preferred.

Responsibilities

• Validate and maintain provider information in databases.
• Ensure adherence to business requirements.
• Participate in special projects.

Skills

Data Analysis

Attention to Detail

Time Management

Education

HS Diploma or GED

Associate's Degree or equivalent

Job description

***Remote and must live in California***

Job Description
Job Summary
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
Knowledge/Skills/Abilities
• Receives information from outside parties for update of provider-related information in computer system(s).
• Reviews/analyzes data by applying job knowledge to ensure appropriate information has been provided.
• Maintains department quality standards for provider demographic data with affiliation and fee schedule attachment.
• Ensures accurate entries of information into health plan systems.
• Works on projects as assigned and within parameters given.
• Conducts or participates in special projects as requested..
Job Qualifications

Required Education
HS Diploma or GED
Required Experience
• Min. 1 year managed care experience
• Experience in one of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
Required License, Certification, Association
N/A
Preferred Education
Associate's Degree or equivalent combination of education and experience
Preferred Experience
• 2+ years managed care experience
• 1+ years in Provider Claims and/or Provider Network Administration

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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