Analyst, Provider Configuration - Documentation & Policy Guidelines- Remote
JOB DESCRIPTION
Job Summary
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.
KNOWLEDGE/SKILLS/ABILITIES
Audits loaded provider records for quality and financial accuracy and provides documented feedback.
Assists in configuration issues and loading of provider information, as needed.
Assists in training current staff and new hires as necessary.
Generates and distributes Network Related Compliance/Regulatory/Accreditation reports.
Generates Provider Related reports to facilitate and support Provider Services/Provider Problem Research & Resolution.
Must be able to write policies and guidelines for different states in QNXT.
Must be knowledgeable on Claims Workflow, Provider data and affiliations, Provider networks, Contracts Credentialling.
Must have experience in working on MS Office Suite, Visio, SharePoint and QNXT is required.
JOB QUALIFICATIONS
Required Education
Associate degree or equivalent combination of education and experience
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $67,725 - $128,519 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Apply Now
Job Summary
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.
KNOWLEDGE/SKILLS/ABILITIES
Audits loaded provider records for quality and financial accuracy and provides documented feedback.
Assists in configuration issues and loading of provider information, as needed.
Assists in training current staff and new hires as necessary.
Generates and distributes Network Related Compliance/Regulatory/Accreditation reports.
Generates Provider Related reports to facilitate and support Provider Services/Provider Problem Research & Resolution.
Must be able to write policies and guidelines for different states in QNXT.
Must be knowledgeable on Claims Workflow, Provider data and affiliations, Provider networks, Contracts Credentialling.
Must have experience in working on MS Office Suite, Visio, SharePoint and QNXT is required.
JOB QUALIFICATIONS
Required Education
Associate degree or equivalent combination of education and experience
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $67,725 - $128,519 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Apply Now