Lead, Core Operations

Job Summary

Molina Healthcare Services (HCS) is required by CMS and state agencies to coordinate benefits when other carriers are responsible for payment. This requires the maintenance of other insurance records and has a direct impact on medical expenses and premium reimbursement.

Knowledge/Skills/Abilities

• Maintains and controls backlog and workflow of claims.
• Coordinates workflow and staffing of day-to-day activities under supervision.
• Serves as a subject matter expert and provides feedback to team personnel.
• Validates and updates other insurance records using phone calls or insurance company portals.
• Implements processes to increase productivity and efficiency.
• Participates in or leads quality improvement efforts to enhance claims processes and policies.

Required Education

Associate's degree or equivalent experience.

Required Experience

• 3 years' experience in billing, claims review, or processing.
• 3 years' experience in managed care or health care industry.

Physical Demands

• Generally favorable working environment with minimal exposure to unpleasant and/or hazardous conditions.
• Must have the ability to sit for long periods.

Reasonable Accommodations

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Application Instructions

To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board.

Benefits and Compensation

Molina Healthcare offers a competitive benefits and compensation package.

Equal Opportunity Employer

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range

Pay Range: $14.76 - $31.97 / HOURLY