**This role will have PST business hours***
Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
Essential Job Duties
• Receives provider information from outside parties for loading/update in internal computer systems and databases; analyzes information and applies knowledge, experience, attention to detail and accuracy to ensure appropriate information has been provided and entry is completed timely and accordance with department standards related to turnaround times and quality.
• Maintains department standard for loading provider demographic data including affiliation and contract assignment.
• Audits loaded provider records for quality and financial accuracy, and provides documented feedback.
• Ensures that provider information is loaded accurately to ensure proper claims processing, outbound reporting and directory processes.
Required Qualifications
• At least 1 year of experience in health care, preferably in a customer/provider services setting, or equivalent combination of relevant education and experience.
• Critical-thinking skills, and attention to detail.
• Organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
• Customer service experience.
• Effective verbal and written communication skills.
• Microsoft Office suite (including Excel) and applicable software program(s) proficiency.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care.
Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
