Job description

JOB DESCRIPTION

Job Summary

Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.

KNOWLEDGE/SKILLS/ABILITIES

Logs and edits claims via the claims system, and researches submitted claims if applicable.

Handles more complex requests for claims processing; escalates where needed.

Contacts appropriate parties to request missing information from requests or for additional information as requested.

Participates in interdepartmental collaboration to enhance the claims processing function.

Meets department quality and production standards.

JOB QUALIFICATIONS

Required Education

HS Diploma or GED

Required Experience

1-3 years

Preferred Education

Associate degree or equivalent combination of education and experience

Preferred Experience

3-5 years

Preferred License, Certification, Association

Certification in Coding, auditing, or billing

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: $ 25,622 - $ 49,962 a year*

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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