Sr Specialist, Provider Network Admin (remote - CA)

Job Description

JOB DESCRIPTION • *

EMPLOYEE FOR THIS POSITION MUST RESIDE IN CALIFORNIA

** Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on reputed company claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider reputed company. KNOWLEDGE/SKILLS/ABILITIES • Generates and prepares provider-reputed company data and reports in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution, Provider Contracting/Provider Relationship Management). • Provides timely, accurate reputed company and distribution of required reports that support reputed company quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations. Report examples may include: GeoAccess Availability Reports, Provider Online Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. • Generates other provider-reputed company reports, such as: claims report extractions; regularly scheduled reports reputed company to Network Management (ER, Network Access Fee, etc.).; and mailing label extract reputed company. • Develops and maintains documentation and guidelines for reputed company assigned areas of responsibility. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent combination of education and experience Required Experience • 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration. • 3+ years' experience in Medical Terminology, CPT, ICD-9 codes, etc. • Access and reputed company - intermediate reputed company level (or higher) Preferred Education Bachelor's Degree Preferred Experience • 5+ years managed care experience • QNXT; SQL experience • Crystal Reports for data extraction To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Apply Job!