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Entry Level Credentialing Jobs in California (NOW HIRING)

US Department of the Navy

$21.77/hr

A qualified candidate possesses the following: Entry Level (CY-1702-01) * Ability to communicate ... OR A valid Child Development Associate (CDA) credential or Military School-Age (MSA) credential; OR ...

CNIC Careers

CYP Educational Aid

Lemoore, CA · On-site

$20.24/hr

A qualified candidate possesses the following: Entry Level (CY-1702-01) * Ability to communicate ... OR A valid Child Development Associate (CDA) credential or Military School-Age (MSA) credential; OR ...

US Department of the Navy

CYP Educational Aid

Lemoore, CA · On-site

$20.24/hr

A qualified candidate possesses the following: Entry Level (CY-1702-01) * Ability to communicate ... OR A valid Child Development Associate (CDA) credential or Military School-Age (MSA) credential; OR ...

CNIC Careers

CYP Educational Aid

Lemoore, CA

$20.24/hr

A qualified candidate possesses the following: Entry Level (CY-1702-01) * Ability to communicate ... OR A valid Child Development Associate (CDA) credential or Military School-Age (MSA) credential; OR ...

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Associate Specialist, National Credentialing

Associate Specialist, National Credentialing

Molina Healthcare

Long Beach, CA • On-site, Remote

$13.41 - $29.06/hr

Full-time

Posted 21 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

144th of 263 rated insurance

Job description


JOB DESCRIPTION Job Summary
Provides entry level support for Molina enterprise credentialing activities. Ensures that the Molina provider network consists of providers that meet all regulatory and risk management criteria - effectively minimizing liability to the company and maximizing safety for members. Responsible for initial credentialing, recredentialing and ongoing monitoring of sanctions and exclusions process for practitioners and health delivery organizations in the Molina network.
Essential Job Duties
• Evaluates credentialing applications for accuracy and completeness based on differences in provider specialty and obtains required verifications as outlined in Molina policies/procedures and regulatory requirements, while meeting production goals.
• Communicates with health care providers to clarify questions and request any missing information.
• Updates credentialing software systems with required information.
• Requests recredentialing applications from providers and conducts follow-up on application requests, following department guidelines and production goals.
• Collaborates with internal and external contacts to ensure timely processing or termination of recredentialing applicants.
• Completes data corrections in the credentialing database necessary for processing of recredentialing applications.
• Reviews claims payment systems to determine provider status, as necessary.
• Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals.
• Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have sanctions/exclusions.
• Reviews and processes daily alerts for Medicare opt-out reports to determine if any provider has opted out of Medicare.
• Reviews and processes daily National Practitioner Data Bank (NPDB) continuous query reports and takes appropriate action when new reports are found.
• Maintains a high level of confidentiality related to provider information.
Required Qualifications
• At least 1 year of experience in a data processing, production, and/or administrative role - preferably in a health care setting, or equivalent combination of relevant education and experience.
• Data entry skills.
• Self-direction and logical thinking abilities.
• Internet research experience.
• Ability to work cross-collaboratively in a highly matrixed organization with internal/external stakeholders.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.
Preferred Qualifications
• Health care industry experience.
• Production-related experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

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.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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