Senior Provider Data & Reports Specialist

Molina Healthcare; United States; Remote; USD 41,000 - 89,000; Full time

Job summary

Molina Healthcare in the United States seeks a Senior Provider Network Specialist to validate and maintain critical provider information across claims and databases, ensuring accuracy and compliance with business and system requirements for provider contracts.

The role includes generating reports, data quality audits, and supporting network operations with training and documentation to improve efficiency and data integrity in a regulated healthcare environment.

Qualifications

• 4+ years of health care experience including claims, provider services, and/or provider network operations.
• Knowledge of CPT/ICD-9/ICD-10 codes and medical terminology.
• Attention to detail and ability to facilitate accurate data entry and review.
• Data entry/processing skills and strong customer service.
• Ability to manage multiple priorities and meet deadlines.
• Strong verbal and written communication; proficient with Microsoft Office.

Responsibilities

• Generates and prepares provider-related data and reports ensuring provider information is accurate in applicable systems.
• Generates reports to support QI, regulatory/accreditation, and provider network operations, and distributes them timely.
• Audits provider records for quality and financial accuracy and provides feedback.
• Maintains documentation and guidelines for assigned areas of responsibility.
• Provides training and support to new and existing provider network administration team members.

Skills

Attention to detail

Data entry

Customer service

Communication skills

Time management

Verbal communication

Tools

Excel

Microsoft Office

Job description

Molina Healthcare in the United States seeks a Senior Provider Network Specialist to validate and maintain critical provider information across claims and databases, ensuring accuracy and compliance with business and system requirements for provider contracts.

The role includes generating reports, data quality audits, and supporting network operations with training and documentation to improve efficiency and data integrity in a regulated healthcare environment.