Specialist, Corp Credentialing - Remote

Lensa; Fort Worth (TX); Remote; Full time

Job summary

A leading healthcare provider is seeking a Credentialing Specialist to manage credentialing processes, ensuring compliance with regulations. This entry-level role involves processing applications, communicating with providers, and monitoring sanctions. Join a team dedicated to maximizing safety in healthcare.

Benefits

Competitive benefits

Qualifications

• Certified Provider Credentialing Specialist (CPCS) or participation in a CPCS progression program required.
• Leadership, guidance, or mentoring experience preferred.

Responsibilities

• Processing credentialing applications and verifying required information.
• Communicating with healthcare providers for clarifications.
• Monitoring provider files for sanctions and exclusions.

Skills

Leadership

Guidance

Mentoring

Education

High School Diploma or GED

Bachelor’s Degree in a related field

Tools

Certified Provider Credentialing Specialist (CPCS)

Job description

Job Description

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!

Job Summary

Molina's Credentialing function ensures that the provider network meets all regulatory and risk management criteria to minimize liability and maximize safety. This position handles initial credentialing, re-credentialing, and ongoing monitoring of sanctions and exclusions for practitioners and organizations, following Molina policies. Responsibilities include meeting production goals and maintaining confidentiality.

Job Duties

• Processing credentialing applications, evaluating for accuracy, completeness, and verifying required information.
• Communicating with healthcare providers for clarifications and missing information.
• Updating credentialing systems with accurate data.
• Managing re-credentialing processes, follow-ups, and data corrections.
• Monitoring provider files for sanctions, exclusions, and Medicare opt-outs, and acting on alerts.

Job Qualifications

Required Education: High School Diploma or GED

Required Experience/Skills: Certified Provider Credentialing Specialist (CPCS) or participation in a CPCS progression program.

Preferred Education: Bachelor’s Degree in a related field

Preferred Experience: Leadership, guidance, or mentoring experience

Additional Information

Interested current Molina employees should apply through the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay Range: $21.16 - $38.37/hour.

Job Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Healthcare Provider

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