3 Administration jobs in Rock Island
Senior Specialist, Provider Network Administration (SQL)
Posted 2 days ago
Job Viewed
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 (using SQL, Excel, and QNXT). 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**
+ Generates and prepares provider-related data and reports (using SQL, Excel and QNXT) in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution, Provider Contracting/Provider Relationship Management).
+ Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations. Report examples may include: GeoAccess Availability Reports, Provider Online Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports.
+ Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree or equivalent combination of education and experience
**Required Experience**
+ 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration.
+ 3+ years' experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 5+ years managed care experience
+ QNXT; SQL experience
+ Crystal Reports for data extraction
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: $45,390 - $88,511.46 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Specialist, Provider Network Administration (EST business hours)
Posted 2 days ago
Job Viewed
Job Description
**This role will have standard EST business hours.**
**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: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Physician / Administration / Illinois / Permanent / Physician Medical Director Opportunity - Join...
Posted today
Job Viewed
Job Description
Concentra Medical Center is searching for a Leader! We are seeking a BC/BE physician who has an unrestricted license, an active DEA, and someone who is eligible to treat Medicare patients. The Center Medical Director (CMD) will lead our Moline, IL location, Monday through Friday, no call and no weekends.Our Center Medical Directors are a vital part of a dedicated team of clinicians committed to exceptional patient care. Additionally, they facilitate efficient and effective center operations by balancing the dynamics of patient care and leadership within a clinical environment. This is an extraordinary opportunity for you to make a difference as you watch your direct leadership impact the health of Americas workforce.BENEFITS SUMMARY:Training provided in our best-in-class Occupational Medicine Process Management ModelCenter Achievement BonusesMedical Malpractice CoverageCME Allowance/Time401(k) with Employer MatchMedical/Vision/Prescription/Dental PlansLife Insurance/DisabilityColleague Referral Bonus ProgramAs the nations largest provider of workplace health services, we proudly own and operate 500+ outpatient clinics across the United States, offering Occupational Medicine, Urgent Care, Physical Therapy and specialist services. We treat one in five work related injuries! The Medical Director role allows for best-in-class physicians to apply their leadership skills while partnering with center staff and colleagues to provide optimal health care for patients.Employees with Concentra enjoy work and life equally in the beautiful Midwest!
Be The First To Know
About the latest Administration Jobs in Rock Island !