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
- Receives information from outside party(ies) for update of information in computer system(s). Analyzes by applying knowledge and experience to ensure appropriate information has been provided.
- Maintains department standard for loading of provider demographic data with affiliation and contract assignment.
- Load and maintain provider information into computer system(s) with attention to detail and accuracy in a timely manner to meet department standards of turnaround time and quality.
- Audit loaded provider records for quality and financial accuracy and provide documented feedback.
- Ensure that provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes.
JOB QUALIFICATIONS
Required Education
HS Diploma or GED
Required Experience
0-3 years
Preferred Education
Associate degree or equivalent combination of education and experience
Preferred Experience
1-3 years
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