Coordinator, Health Plan Credentialing-Ohio

Credentialing Coordinator

Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria in order to minimize liability to the company and to maximize safety for members. Responsible for coordinating assigned provider credentialing and other administrative activities for the state health plan.

Job Duties

Sends standardized form letters notifying providers of credentialing decision within timeframe specified by health plan. Updates the credentialing database for all providers after the decision-making portion of the credentialing process. Generates and distributes CACTUS reports as required. Answers credentialing questions from providers and internal contacts. Researches weekly reports posted by MHI Credentialing to ensure providers submit necessary information to complete the credentialing process. Provides monthly report to MHI Credentialing of all providers who have terminated for all lines of business. Supports and completes ongoing projects as assigned.

Job Qualifications

Required Education : High School Diploma or GED.

Required Experience / Knowledge Skills & Abilities : Experience in a production or administrative role requiring self-direction and critical thinking. Extensive experience using a computer specifically internet research, Microsoft Outlook and Word, and other software systems.

Preferred Education : Post-high school education in administration or health care. Experience in the health care industry.

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.