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). 
• Coordinates preparation and routing distribution of documents to complete the contracting/credentialing process in a timely and thorough manner according to standardized process.
• Reviews/analyzes contracts and amendments, including but not limited to fee for Service and Alternative Payment Methods including Pay for Performance.
• Understanding credentialing requirements and regulations.
• 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.. 
  

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
•  Extensive experience using a computer - specifically internet research, Microsoft Excel, Outlook and Word, and other software systems.

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.