Specialist, Provider Network Administration (IOWA)

Molina Healthcare; United States; On-site; USD 42,000 - 52,000; Full time

Job summary

Molina Healthcare is seeking a detail-oriented professional to manage provider data updates and ensure integrity across health plan systems. You will review information from external parties, maintain accurate demographic and fee-schedule records, and support provider network projects.

The role emphasizes data accuracy, multi-tasking, and strong communication while working with cross-functional teams in a healthcare setting. Iowa-based candidates are highly preferred.

Qualifications

• At least 3 years of health care experience or equivalent.
• Strong data entry and review abilities with attention to detail.
• Customer service skills and ability to handle multiple priorities.
• Effective verbal and written communication skills.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Receives information from external parties for provider data updates.
• Reviews and analyzes data to ensure completeness and accuracy.
• Maintains provider demographic data with affiliations and fee schedules.
• Ensures accurate entries into health plan systems.
• Audits provider records for quality and financial accuracy and provides feedback.
• Assists in resolving configuration issues with cross-functional teams.
• Provides support for provider network administration projects.

Skills

Data entry

Attention to detail

Customer service

Multi-tasking

Verbal and written communication

Tools

Microsoft Office

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