JOB DESCRIPTION

Job Summary

Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

KNOWLEDGE/SKILLS/ABILITIES

KNOWLEDGE/SKILLS/ABILITIES

•        Knowledge of configuration in QNXT and Benefits is required.

•        Understanding of configuration solutions and ability to use critical thinking to analyze claims issues.

•        Works with internal and external stakeholders to understand business objectives and processes associated with the enterprise.

•     Participates in the implementation and conversion of new and existing health plans including development and execution of test plans.

•        Mentors junior analysts and trains them on configuration functionality, enhancements, and updates.

•        Experience working with Marketplace or Commercial Lines of Business is preferred.

•        Experience working with SQL is required.

• Prior Exp working in medical coding and  billing is preferred.

JOB QUALIFICATIONS

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

5-7 years

Preferred Education

Graduate Degree or equivalent experience

Preferred Experience

7-9 years

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.

Pay Range: $54,373.27 - $117,808.76 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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.