Provider Network Data Quality Specialist

Molina Healthcare; New York (NY); Remote; USD 55,000 - 70,000; Full time

Benefits offered by this job

Competitive benefits

Equal opportunity employer

Job summary

Molina Healthcare in New York, NY is seeking a provider network administrator to support data maintenance for provider information across claims and provider databases.

The role requires healthcare experience, accuracy, data entry skills, strong customer service, and proficiency with Microsoft Office; you will validate data and assist in network projects.

You will liaise with internal teams and external parties to ensure compliant, timely updates and quality records.

Qualifications

• At least 3 years of health care experience, to include experience in claims, provider services, provider network operations, and/or hospital/physician billing, or equivalent combination of relevant education and experience.
• Claims processing experience, including coordination of benefits, subrogation, and/or eligibility criteria.
• Attention to detail, and ability to facilitate accurate data entry/review.
• Data entry/processing skills.
• Customer service skills.
• Ability to manage multiple priorities and meet deadlines.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.

Responsibilities

• Receives information from outside parties for update of provider-related information in applicable 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.
• Audits loaded provider records for quality and financial accuracy, and provides documented feedback.
• Assists in resolution of configuration issues with applicable teams.
• Provides support for provider network administration projects.

Skills

Healthcare experience

Claims processing

Attention to detail

Data entry

Customer service

Multitasking

Verbal and written communication

Microsoft Office proficiency

Tools

Microsoft Office

Job description

Molina Healthcare in New York, NY is seeking a provider network administrator to support data maintenance for provider information across claims and provider databases.

The role requires healthcare experience, accuracy, data entry skills, strong customer service, and proficiency with Microsoft Office; you will validate data and assist in network projects.

You will liaise with internal teams and external parties to ensure compliant, timely updates and quality records.