Molina Healthcare

Molina Healthcare

Analyst, Pre-Pay Dispute Coding (Remote)

United States

Sponsorship not specifiedDetected 3 days ago
AuditingICD-10CommunicationMicrosoft Office

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odds of building a lasting career here

31Risky
Cap-exempt (no lottery)0
Sponsors this role58
Entry-level history0
PERM / green-card track0
Lottery odds40
Fits your clock70

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Employer immigration record

from this employer's Department of Labor filings

Green-card filing pattern in this occupation

Context, not a finding about this posting: of this employer's 7 green-card filings in this occupation, 100% were for a worker who already held the job.

Green-card follow-through: 40%

Of 5 labor certifications old enough to have been used, 3 expired without the employer filing the next step. Median time from filing to decision: 500 days.100% of their filings were for a worker who already held the job.Only certifications past the 180-day window are counted — recent ones cannot have expired yet.

Files H-1B transfers

2 transfer filings in the last year, covering 2 workers. Median labor-condition decision: 8 days. An employer that already files transfers is one that can take over an existing H-1B.

Sourced from Department of Labor LCA, PERM and prevailing-wage disclosure data. Employer matching is by name, so figures may be split across an employer's legal entities. Absence of a filing means none appears in our copy of the data, not that none exists.

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About the role

  • Investigates and resolves disputes related to provider appeals, and ensures that claims adhere to correct billing standards and regulations.
  • Conducts independent audits of non-medical records to verify billing accuracy; makes decisions within designated authority to either overturn or uphold denials in a timely manner.
  • Generates and communicates determination to the provider using appropriate letter language and provides necessary guideline links.

Responsibilities

  • Provides support for provider denial coding dispute activities. Investigates and resolves disputes related to provider appeals, and ensures that claims adhere to correct billing standards and regulations.
  • Provides support for provider denial coding dispute activities.
  • Actively participates in the enhancement of departmental processes to maintain alignment with current coding regulations and guidelines, while also refining internal procedures.
  • Identifies, documents, and communicates any identified coding errors or inconsistencies; collaborates with appropriate internal departments to capture and track issues, and ensure precise code editing and compliance.

Requirements

  • Ability to work cross-collaboratively in a highly matrixed organization.
  • Microsoft Office suite and applicable software program(s) proficiency.
  • To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Compensation

  • Molina Healthcare offers a competitive benefits and compensation package.

Benefits

  • At least 2 years of experience in medical coding or billing, or equivalent combination of relevant education and experience.
  • Strong attention to detail and ability to independently read and comprehend the details of medical records.
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This listing is sourced directly from Molina Healthcare's careers page and normalized into a canonical job model.