Demographic area: This position is responsible for accurately entering provider demographic and contract affiliation information into the health plan system. Must be able to accurately interpret request and enter into the system in such a way that all data is correct and claims adjudication is optimized.
Duties and Responsibilities
• Receive information from outside party(ies) for update of information in computer system(s).
• Analyze by applying knowledge and experience to ensure appropriate information has been provided.
• 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.
• Assist in system/health plan integration.
• Train current staff and new hires as necessary.
• Assist in system related testing.
Knowledge, Skills and Abilities
• Excellent attention to detail
• Ability to enter information in a timely manner
• Good project management skills
• Able to meet deadlines and time constraints
• Strong knowledge of Microsoft office including Outlook, Word, Excel, and Access
• Ability to lean internal systems QNXT
• Excellent verbal and written communication skills
• Ability to abide by Molina’s policies
• Maintain regular attendance based on agreed-upon schedule
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
• Other duties as assigned.
- High School Diploma or equivalent GED
- 2 years managed care experience
- 4 + yrs. managed care experience
To all current Molina employees if you are interested in applying for this position please fill out an Employee Transfer Request Form (ETR) and attach it to your profile when applying online. Be sure to let us know you are a current employee by selecting “Molina Employee (current) in the source section of the online application.
Molina Healthcare offers competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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