Tribal Liaison (Billing & Claims) Remote in New Mexico
Company: Molina Healthcare
Location: Albuquerque
Posted on: April 16, 2024
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Job Description:
Molina Healthcare is hiring in New Mexico for several Billing &
Claims, Tribal Liaisons. -These roles are specifically responsible
-for working with tribal entities regarding billing and claims
support and resolution activities.
Highly qualified candidates will have strong communication skills,
excellent Microsoft Office product knowledge, and experience with
Native American provider relationship management. -
These roles are remote, candidate must reside in New Mexico, as
there may need to travel within the state according to business
needs. -
Strong claims knowledge and IHS is required.
Job SummaryResponsible for continuous quality improvements
regarding member engagement and member retention. - Represents
Member issues in areas involving member impact and engagement
including: Appeals and Grievances, Member Problem Research and
Resolution, and the development/maintenance of Member Materials.
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Knowledge/Skills/AbilitiesAssists Molina Healthcare in promoting
Native American's access to healthcare coverage and educates
communities about the general and value added services provided by
Molina Healthcare. Responsible for building and maintaining
relationships with tribal community leaders, community-based
organizations and providers within tribal lands and reservations
through a combination of direct and indirect outreach and
engagement activities directed toward building enrollment for all
Health Plan lines of business. Establishes formal working
relationships with and acts as a central point of contact to the
Indian Health Services (IHS) facilities and tribal 638 facilities.
Interacts with other Molina Healthcare departments to improve
services provided to Native American members, prospective members,
IHS and tribal 638 providers. As requested, helps support Molina
Healthcare's relationship with IHS and tribal 638 facilities and
establishes relationships with tribal employers.
Job QualificationsRequired Education: - -High School Diploma or
GEDPreferred Education: -Bachelor's Degree preferredRequired
Experience:3-5 years experience in healthcare industry, preferably
in the Medicaid Managed Care ProgramsPrevious healthcare marketing
and/or grassroots/community outreach experience
Preferred Experience:Experience in the Medicaid Managed Care
ProgramsExperience with behavioral health and/or coordination of
Long-Term Services preferred
Required License, Certification, Association:Must have valid
driver's license with good driving record and be able to drive
within applicable state or locality with reliable
transportation.
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.
Key Words: Billing, Claims, Reconcile, IHS, Indian Health Services,
Tribal Liaison, Medicaid, MCO, Managed Care, Tribal, Value Added,
Community, -Tribal 638, Tribal Governments, TCBOs, HSD/MAD, Claims
Examiner, Auditor, Claims Processor, -
#PJHPO
#LI-AC1 Pay Range: $40,851.44 - $88,511.46 / ANNUAL
*Actual compensation may vary from posting based on geographic
location, work experience, education and/or skill level.
Keywords: Molina Healthcare, Rio Rancho , Tribal Liaison (Billing & Claims) Remote in New Mexico, Other , Albuquerque, New Mexico
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