Specialist, Provider Network Administration (IOWA)

Molina Healthcare Inc; Iowa (LA); On-site; USD 42,000 - 52,000; Full time

Job summary

Molina Healthcare Inc is seeking a detail-oriented health care data entry professional based in Iowa. The role focuses on updating provider-related information across core systems, ensuring accuracy and compliance with provider networks and fee schedules.

Ideal candidates have 3+ years in healthcare operations, strong data entry skills, and solid communication abilities to coordinate with internal teams and external partners. This position emphasizes accuracy, multitasking, and customer service.

Qualifications

• 3+ years of health care experience, including claims/provider services
• Attention to detail and ability to facilitate accurate data entry/review
• Data entry/processing skills
• Customer service and communication skills
• Ability to manage multiple priorities and meet deadlines

Responsibilities

• Receives information from outside parties to update provider-related information in computer systems
• Reviews and analyzes data to ensure completeness and accuracy
• Maintains provider demographic data with affiliation and fee schedule attachments
• Ensures accurate entries into health plan systems
• Audits provider records for quality and financial accuracy
• Assists in resolving configuration issues with applicable teams
• Supports provider network administration projects

Skills

Attention to detail

Data entry

Customer service

Communication

Microsoft Office

Tools

Microsoft Excel

Microsoft Office Suite

Job description

Candidates based in IOWA are highly preferred.

JOB DESCRIPTION Job Summary

Essential Job Duties

• 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.

Required 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.
• 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.

Preferred Qualifications

• Experience with medical terminology, Current Procedural Terminology (CPT), International Classification of Diseases (ICD-9, ICD-10) codes, etc.
• Intermediate Microsoft Excel skills.
• Claims processing experience, including coordination of benefits, subrogation, and/or eligibility criteria.

• Molina Healthcare offers a competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V