Associate Provider Services Representative Job at Molina Healthcare
JOB DESCRIPTION
***Remote and must live in Michigan***
Job Summary
Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.
KNOWLEDGE/SKILLS/ABILITIES
Provides support to the Provider Services Team regarding receiving, researching, and responding to provider inquiries.
Receives, researches, and resolves provider inquiries such as claims, eligibility, and other inquiries. Act as a liaison between the providers, medical groups, and health plan.
Duties may include: (a) Price specific services based on the Plan's fee schedule; (b) Communicate and educate providers on important changes to regulations, procedures, and access to information; (c) Assist Providers in dismissing or moving members incorrectly assigned to them; and/or (d) Educate providers so the appropriate dismissal letters are sent to Molina members.
Supports other members of the Provider Services Team when they are in the field.
Responsible for documenting requests as required in departmental procedures.
Assists with training of new Provider Services staff members.
Attends off-site meetings when necessary with medical groups and other providers as needed.
Complies with required workplace safety standards.
JOB QUALIFICATIONS
Required Education
High School Diploma or equivalent GED
Required Experience
1 year customer service, provider service, or claims experience in a managed care or medical office setting.
Preferred Education
Associate degree
Vocational program in Managed Care or some other health care aspect providing a certificate at completion.
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: $16.40 - $31.97 an hour*
Please Note :
caminobluff.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, caminobluff.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
***Remote and must live in Michigan***
Job Summary
Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.
KNOWLEDGE/SKILLS/ABILITIES
Provides support to the Provider Services Team regarding receiving, researching, and responding to provider inquiries.
Receives, researches, and resolves provider inquiries such as claims, eligibility, and other inquiries. Act as a liaison between the providers, medical groups, and health plan.
Duties may include: (a) Price specific services based on the Plan's fee schedule; (b) Communicate and educate providers on important changes to regulations, procedures, and access to information; (c) Assist Providers in dismissing or moving members incorrectly assigned to them; and/or (d) Educate providers so the appropriate dismissal letters are sent to Molina members.
Supports other members of the Provider Services Team when they are in the field.
Responsible for documenting requests as required in departmental procedures.
Assists with training of new Provider Services staff members.
Attends off-site meetings when necessary with medical groups and other providers as needed.
Complies with required workplace safety standards.
JOB QUALIFICATIONS
Required Education
High School Diploma or equivalent GED
Required Experience
1 year customer service, provider service, or claims experience in a managed care or medical office setting.
Preferred Education
Associate degree
Vocational program in Managed Care or some other health care aspect providing a certificate at completion.
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: $16.40 - $31.97 an hour*
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Please Note :
caminobluff.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, caminobluff.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.