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Associate Specialist, Provider Network Administrator-Florida

Associate Specialist, Provider Network Administrator-Florida

Molina HealthcareJacksonville, FL, US
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Job Description

Job Summary

Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all 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 contracts.

Knowledge / Skills / Abilities

  • Receives information from outside parties for update of provider-related information in computer system(s).
  • Reviews / analyzes data by applying job knowledge to ensure appropriate information has been provided.
  • Maintains department quality standards for provider demographic data with affiliation and fee schedule attachment.
  • Ensures accurate entries of information into health plan systems.
  • Works on projects as assigned and within parameters given.
  • Conducts or participates in special projects as requested
  • Excel Experience

Job Qualifications

Required Education

HS Diploma or GED

Required Experience

  • Min. 1 year managed care experience
  • Experience in one of the following : Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
  • Required License, Certification, Association

    N / A

    Preferred Education

    Associate's Degree or equivalent combination of education and experience

    Preferred Experience

  • 2+ years managed care experience
  • 1+ years in Provider Claims and / or Provider Network Administration
  • Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V.

    Pay Range : $13.55 - $26.42 / HOURLY

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
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