Assoc Specialist, National Credentialing (Provider Credentialing) Remote
About The Position
Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to maximize safety for members. This position is responsible for the initial credentialing, recredentialing and ongoing monitoring of sanctions and exclusions process for practitioners and health delivery organizations according to Molina policies and procedures. This position is also responsible for meeting daily/weekly production goals and maintaining a high level of confidentiality for provider information.
Requirements
- High School Diploma or GED.
- Experience in a production or administrative role requiring self-direction and critical thinking.
- Extensive experience using a computer -- specifically internet research, Microsoft Outlook and Word, and other software systems.
- Experience with professional written and verbal communication.
Nice To Haves
- Experience in the health care industry
- Experiece with Provider credentialling
Responsibilities
- Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have sanctions/exclusions.
- Reviews and processes daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of Medicare.
- Reviews and processes daily NPDB Continuous Query reports and takes appropriate action when new reports are found.
Benefits
- Molina Healthcare offers a competitive benefits and compensation package.
- Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
