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As part of Molina’s response to the COVID-19 pandemic, unless otherwise prohibited by law, new hires with a start date of November 1, 2021 or later will be required to be fully vaccinated.

Assoc Specialist, Provider Contracts

Molina Healthcare Bothell, Washington Job ID 2010327
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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

  • Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Service team members.
  • Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures.
  • Forwards requested information/documentation to prospective providers in a timely manner.
  • Maintains database of all contracts and specific applications sent to prospective new providers.
  • Completes and updates (CIF) form for each new contract.
  • Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team.
  • Sends out new provider welcome packets to providers who have contracted with the plan.
  • Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management.
  • Formats and distributes Provider network resources (e.g. electronic specialist directory).

JOB QUALIFICATIONS

Required Education

High School Diploma or equivalent GED

Required Experience

1 year customer service, provider service, contracting or claims experience in the healthcare industry.

Preferred Education

Associate degree or bachelor’s degree in a related field or an equivalent combination of education and experience

Preferred Experience

Managed Care 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.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 10/15/2021

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