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 ...
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Provider information
See Nevada salary details
$13.94 is the 25th percentile. Wages below this are outliers.
$10.53 - $18.72
60% of jobs
$24.27 is the 75th percentile. Wages above this are outliers.
$18.72 - $26.90
22% of jobs
$26.90 - $35.09
1% of jobs
$35.09 - $43.28
0% of jobs
$43.28 - $51.47
1% of jobs
$51.47 - $59.66
1% of jobs
$59.66 - $67.85
1% of jobs
$67.85 - $76.04
6% of jobs
$76.04 - $84.23
1% of jobs
$84.23 - $92.42
0% of jobs
$92.42 - $100.61
6% of jobs
$10
$32
$100
How much do provider jobs pay per hour?
What type of job is a provider?
What are the key skills and qualifications needed to thrive as a healthcare provider, and why are they important?
How does a provider typically collaborate with other healthcare professionals to ensure comprehensive patient care?
What is a provider?
What is the difference between Provider vs Nurse?
| Aspect | Provider | Nurse |
|---|---|---|
| Credentials | Medical degree (MD, DO), licensing | RN license, nursing certifications |
| Work Environment | Clinics, hospitals, private practices | Hospitals, clinics, long-term care facilities |
| Role & Responsibilities | Diagnose, treat, prescribe medications | Patient care, monitoring, assisting in procedures |
Providers, such as physicians, have advanced medical degrees and can diagnose and prescribe treatments. Nurses focus on patient care, monitoring, and supporting providers. Both roles are essential in healthcare, but providers have broader clinical responsibilities and prescribing authority, while nurses provide vital ongoing patient support.

Full-time
Posted 16 days ago
Molina Healthcare rating
8.0
Based on 198 frontline employees who took The Breakroom Quiz
164th of 303 rated insurance
Job description
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
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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