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Provider Network Remote information

What is the difference between Provider Network Remote vs Provider Relations Specialist?

AspectProvider Network RemoteProvider Relations Specialist
CredentialsTypically requires healthcare or insurance certificationsSimilar certifications, often including healthcare administration
Work EnvironmentRemote, independent work with healthcare providersOffice or remote, focusing on communication with providers
Industry UsageUsed in health insurance and managed care organizationsCommon in insurance companies and healthcare networks
Search & Comparison IntentUnderstanding remote provider network rolesLearning about provider relations and communication roles

Provider Network Remote and Provider Relations Specialist roles share similar credentials and industry settings, but differ mainly in focus. Provider Network Remote emphasizes managing provider networks remotely, while Provider Relations Specialists focus on building relationships and communication with providers, often in an office setting.

What are the most commonly searched types of Provider Network jobs in New York? The most popular types of Provider Network jobs in New York are:
What are popular job titles related to Provider Network Remote jobs in New York? For Provider Network Remote jobs in New York, the most frequently searched job titles are:
What job categories do people searching Provider Network Remote jobs in New York look for? The top searched job categories for Provider Network Remote jobs in New York are:
What cities in New York are hiring for Provider Network Remote jobs? Cities in New York with the most Provider Network Remote job openings:
Provider Network Remote jobs near you

Specialist, Provider Network Administration - Remote

Molina Healthcare

New York, NY • On-site, Remote

$18.04 - $42.20/hr

Full-time

Posted 4 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 198 frontline employees who took The Breakroom Quiz

163rd of 304 rated insurance

Job description


JOB DESCRIPTION Job Summary
Provides support for provider network administration activities. Responsible for accurate and timely validation and maintenance of critical provider information on all claims and provider databases, and ensures adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
Essential Job Duties
• Receives information from outside parties for update of provider-related information in applicable computer system(s).
• Reviews/analyzes data by applying job knowledge to ensure appropriate information has been provided.
• Maintains department quality standards for provider demographic data with affiliation and fee schedule attachment.
• Ensures accurate entries of information into health plan systems.
• Audits loaded provider records for quality and financial accuracy, and provides documented feedback.
• Assists in resolution of configuration issues with applicable teams.
• Provides support for provider network administration projects.
Required Qualifications
• At least 3 years of health care experience, to include experience in claims, provider services, provider network operations, and/or hospital/physician billing, or equivalent combination of relevant education and experience.
• Claims processing experience, including coordination of benefits, subrogation, and/or eligibility criteria.
• Attention to detail, and ability to facilitate accurate data entry/review.
• Data entry/processing skills.
• Customer service skills.
• Ability to manage multiple priorities and meet deadlines.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.
Preferred Qualifications
• Experience with medical terminology, Current Procedural Terminology (CPT), International Classification of Diseases (ICD-9, ICD-10) codes, etc.
• Intermediate Microsoft Excel skills.
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

What Molina Healthcare employees say

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About Molina Healthcare

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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

Social media

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