Analyst, Provider Configuration - Documentation & Policy Guidelines- Remote

Job Description

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.

Job Info

Job Identification: 2028848

Job Category: Operations

Posting Date: 2024-12-30T22:14:04 00:00

Job Schedule: Full time