Provider Claims Adjudicator: Quick Resolutions & Support

Molina Healthcare, Inc.; United States; Remoto; USD 40.000 - 60.000; Tempo pieno

Descrizione del lavoro

Molina Healthcare, Inc. is seeking a provider claims support specialist to assist with responding to providers, researching claim issues, and ensuring timely, accurate resolution.

You will collaborate with claims processing, member enrollment, and benefits teams to address provider questions, document calls, and meet quality and production standards.

The role emphasizes customer service, data analysis, and clear communication to maintain high satisfaction and efficient operations.

Competenze

• At least 2 years of clerical experience in claims or customer service within a managed care setting.
• Experience researching and resolving provider claim issues and reimbursement methods.
• Strong data analysis and attention to detail to ensure accurate resolutions.
• Effective verbal and written communication with providers and internal teams.

Mansioni

• Supports resolution of provider claims issues, analyzes systems, and collaborates with provider billing to resolve.
• Responds to provider calls regarding claims inquiries with strong customer service and documents interactions.
• Collaborates with enrollment and benefits teams to address provider claim questions and issues.
• Assists in reviews of state and federal complaints related to claims and supports process improvements.

Conoscenze

Research and data analysis

Customer service

Verbal and written communication

Time-management

Attention to detail

Microsoft Office proficiency

Formazione

High school diploma or equivalent

Strumenti

Provider claims systems

Descrizione del lavoro

Molina Healthcare, Inc. is seeking a provider claims support specialist to assist with responding to providers, researching claim issues, and ensuring timely, accurate resolution.

You will collaborate with claims processing, member enrollment, and benefits teams to address provider questions, document calls, and meet quality and production standards.

The role emphasizes customer service, data analysis, and clear communication to maintain high satisfaction and efficient operations.