Specialist, Provider Network Admin
2 weeks ago
**_***Remote and must live in Wisconsin***_**
**JOB DESCRIPTION**
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Oversees receipt of and coordinates data from the provider network for entry into the plan's provider management system.
+ Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.
+ Audits loaded provider records for quality and financial accuracy and provides documented feedback.
+ Assists in configuration issues with Corporate team members.
+ Assists in training current staff and new hires as necessary.
+ Conducts or participates in special projects as requested.
**JOB QUALIFICATIONS**
**Required Education**
Associate degree in Business or equivalent combination of education and experience
**Required Experience**
+ Min. 3 years managed care experience
+ Experience in one or more of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
+ Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria.
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 3+ years Provider Claims and/or Provider Network Administration experience
+ Experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
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: $16.23 - $35.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
-
Provider Reimbursement Specialist
4 weeks ago
Madison, United States Productive Processing, Inc. Full timeThe Provider Reimbursement Specialist is responsible for configuring the provider pricing information in the claims processing system. The Provider Reimbursement Specialist facilitates the pricing of medical claims, utilizing provider contracts and schedules including Medicare, Medicaid, UCR and Network contracts. This position will also handle any inquiries...
-
Digital Support Specialist
2 weeks ago
Madison, United States Gordon Flesch Company Full timeOffering an opportunity to be part of a high-performance team, enjoy exceptional benefits, and a supportive work-life balance, the Gordon Flesch Company is an employer of choice throughout WI, IL, IN, IA and OH. The Gordon Flesch Company strives to recognize and appreciate our associate's commitment, creativity, and the results they deliver every day for our...
-
Digital Support Specialist
6 days ago
Madison, United States Gordon Flesch Company Full timeOffering an opportunity to be part of a high-performance team, enjoy exceptional benefits, and a supportive work-life balance, the Gordon Flesch Company is an employer of choice throughout WI, IL, IN, IA and OH. The Gordon Flesch Company strives to recognize and appreciate our associate's commitment, creativity, and the results they deliver every day...
-
Digital Support Specialist
4 days ago
Madison, United States Gordon Flesch Company Full timeOffering an opportunity to be part of a high-performance team, enjoy exceptional benefits, and a supportive work-life balance, the Gordon Flesch Company is an employer of choice throughout WI, IL, IN, IA and OH. The Gordon Flesch Company strives to recognize and appreciate our associate's commitment, creativity, and the results they deliver every day for our...
-
Digital Support Specialist
2 weeks ago
Madison, United States Gordon Flesch Company Full timeJob DescriptionJob DescriptionOffering an opportunity to be part of a high-performance team, enjoy exceptional benefits, and a supportive work-life balance, the Gordon Flesch Company is an employer of choice throughout WI, IL, IN, IA and OH. The Gordon Flesch Company strives to recognize and appreciate our associate’s commitment, creativity, and the...
-
Madison, United States UnityPoint Health Full time13463 BRFTE: 1.0 Shift: Weekdays, day shift. Compensation: Starting at $21.20, commensurate with experience. Hours Per Week: 40 Weekends: No. Benefit Eligible. Responsible for all aspects of the provider enrollment and credentialing process for g Enrollment, Specialist, Healthcare, Shift, Credentialing
-
Network Engineer
2 weeks ago
Madison, United States Ageatia Global Solutions Full timeThe services provided by this position will be to assist in the management and support of Network Access Management Infrastructure Services and Agency Transitions. This infrastructure and transition work includes activities such as keeping agencies and enterprise F5, Cisco and Palo Alto Firewalls at current levels, researching and installing new and/or ...
-
Network Engineer
4 days ago
Madison, United States Ageatia Global Solutions Full timeThe services provided by this position will be to assist in the management and support of Network Access Management Infrastructure Services and Agency Transitions. This infrastructure and transition work includes activities such as keeping agencies and enterprise F5, Cisco and Palo Alto Firewalls at current levels, researching and installing new and/or ...
-
Provider Contracting Director
1 week ago
Madison, United States The Jacobson Group Full timeJob Description: A health insurance company is seeking a Provider Contracting Director. The Provider Contracting Director will beresponsible forimplementing front-end contracting with providers and health systems, includingthe execution, negotiation and management of contracts. Thisis a relationship-based role that will have a high degree of visibility with...
-
Associate Field Network Engineer
2 weeks ago
Madison, United States Impact Networking Full timeDescription Impact is hiring an Associate Field Network Engineer for our Nationally ranked Best and Brightest Workplace! The Associate Field Network Engineer (AFNE) will be utilized in many different capacities to ensure client onboarding and ongoing maintenance is completed on time and to Impact standards. The Associate FNE will support the MIT team in all...
-
Network Manager
4 weeks ago
Madison, United States UW Health Full time**Work Schedule**: This is a full-time, 40 hours per week position scheduled to work Monday through Friday, with core hours between the hours of 8:00 AM - 5:00 PM. Applicants hired into this position can work hybrid from most states. This will be discussed during the interview process. **Be part of something remarkable** Join the #1 hospital in...
-
Network Manager
2 weeks ago
Madison, United States UW Health Full timeJob Description Work Schedule: This is a full-time, 40 hours per week position scheduled to work Monday through Friday, with core hours between the hours of 8:00 AM - 5:00 PM. Applicants hired into this position can work hybrid from most states. This will be discussed during the interview process. Be part of something remarkable Join the #1 hospital in...
-
Network Manager
4 days ago
Madison, United States UW Health Full timeJob Description Work Schedule: This is a full-time, 40 hours per week position scheduled to work Monday through Friday, with core hours between the hours of 8:00 AM - 5:00 PM. Applicants hired into this position can work hybrid from most states. This will be discussed during the interview process. Be part of something remarkable Join the #1 hospital in...
-
Customer Care Specialist
4 weeks ago
Madison, United States Energy Services, Inc. Full timeThe primary mission of Energy Services is to provide limited income families with the services and assistance necessary to prevent and or alleviate energy-related emergencies from occurring, while promoting initiatives that result in a family’s long-term self-sufficiency. Pay: $18.00 per hour Key words: call center, customer care, nonprofit,...
-
Networking Support Technician
59 minutes ago
Madison, United States PassionHR Inc Full timeNETWORKING SUPPORT TECHNICIAN PassionHR is an HR consulting firm committed to serving our client's goals, which often involves business- to- business recruiting to hire, manage, and retain top-talent employees. PassionHR is currently seeking to hire a Networking Support Technician for a client in the Huntsville, AL area. The hiring company was founded as an...
-
Networking Support Technician
2 days ago
Madison, United States PassionHR Inc Full timeNETWORKING SUPPORT TECHNICIAN PassionHR is an HR consulting firm committed to serving our client's goals, which often involves business- to- business recruiting to hire, manage, and retain top-talent employees. PassionHR is currently seeking to hire a Networking Support Technician for a client in the Huntsville, AL area. The hiring company was founded as an...
-
Network Engineer III Implementation and
2 weeks ago
Madison, United States Charter Communications Full timeJOB REQUIREMENTS: Do you want to guide the identification, forecasting and implementation of resource requirements? You can do that. Ready to mentor less experienced team members while serving as a lead on department projects? As a Network Engineer III at Spectrum Enterprise, you can do that. provides modern enterprise technology solutions that meet the...
-
Network Engineer III Implementation and
4 days ago
Madison, United States Charter Communications Full timeJOB REQUIREMENTS: Do you want to guide the identification, forecasting and implementation of resource requirements? You can do that. Ready to mentor less experienced team members while serving as a lead on department projects? As a Network Engineer III at Spectrum Enterprise, you can do that. provides modern enterprise technology solutions that meet the...
-
Network Security Engineer
2 weeks ago
Madison, United States Spero Technology Full timeQualifications We are looking for a skilled and experienced Network Security Engineer with expertise in both Fortinet and Cisco technologies Bachelor's degree in Computer Science, Information Security, or a related field Proven experience in configuring and managing Fortinet and Cisco network security solutions Strong understanding of Fortinet FortiGate...
-
Network Security Engineer
4 days ago
Madison, United States Spero Technology Full timeQualifications We are looking for a skilled and experienced Network Security Engineer with expertise in both Fortinet and Cisco technologies Bachelor's degree in Computer Science, Information Security, or a related field Proven experience in configuring and managing Fortinet and Cisco network security solutions Strong understanding of Fortinet FortiGate...