Analyst, Provider Configuration - Documentation & Policy Guidelines- Remote

Remote Full-time
About the position The Analyst, Provider Configuration role at Molina Healthcare is responsible for the accurate and timely maintenance of critical provider information across various claims and provider databases. This position involves synchronizing data among multiple systems, validating provider data, and ensuring compliance with business and system requirements related to contracting, network management, and credentialing. Responsibilities • Maintain critical provider information on all claims and provider databases. • Synchronize data among multiple claims systems and apply business rules as they pertain to each database. • Validate data to be housed on provider databases and ensure adherence to business and system requirements. • Audit loaded provider records for quality and financial accuracy and provide documented feedback. • Assist in configuration issues and loading of provider information as needed. • Assist in training current staff and new hires as necessary. • Generate and distribute Network Related Compliance/Regulatory/Accreditation reports. • Generate Provider Related reports to facilitate and support Provider Services/Provider Problem Research & Resolution. • Write policies and guidelines for different states in QNXT. • Demonstrate knowledge of Claims Workflow, Provider data and affiliations, Provider networks, and Contracts Credentialing. Requirements • Associate degree or equivalent combination of education and experience. • Experience working with MS Office Suite, Visio, SharePoint, and QNXT. Nice-to-haves • Bachelor's Degree or equivalent combination of education and experience. Benefits • Competitive benefits and compensation package. Apply tot his job
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