Role Description Provides support through the investigation and resolution of disputes related to provider appeals, ensuring that claims adhere to correct billing standards and regulations. - Reviews coding-related provider claims denials by systematically examining medical records, denial reasons, submitted claims, and claim history, in accordance with applicable state, federal, and Molina guidelines, rules, and protocols, to determine whether the documentation substantiates the services rendered. - Conducts independent audits of non-medical records to verify billing accuracy, making decisions within designated authority to either overturn or uphold denials in a timely manner. - Generates and communicates the determination to the provider using appropriate letter language and providing any necessary guideline links. - Identifies, documents, and communicates any identified coding errors or inconsistencies, collaborating with appropriate internal department(s) to capture and track issues to ensure precise code editing and compliance. - Completes data points within internal applications to comply with auditing requirements used within the departments of Molina. - Actively participates in the enhancement of departmental processes to maintain alignment with current coding regulations and guidelines, while also refining internal procedures. Qualifications - At least 2 years of experience in medical coding or billing. - Active and unrestricted Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification. - Strong attention to detail and ability to independently read and comprehend the details of medical records. - Comfortable working in a production-centric environment with high quality standards. - Ability to use Microsoft Office including Outlook, Word, and Excel. Requirements - To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Benefits - Molina Healthcare offers a competitive benefits and compensation package. - Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

- Writing, optimizing, and troubleshooting SQL queries and stored procedures against the Yardi database for reporting, data validation, and ad-hoc analysis - Designing, building, and maintaining Power BI dashboards and reports for operational, leasing, and financial KPIs - Developing advanced Excel models, pivot tables, and reconciliations to support month-end close, audits, and recurring reporting - Partnering with the Database Administrator on data integrity checks, performance tuning, and routine database maintenance - Translating accounting, operations, and leadership requirements into technical specifications and deliverables - Investigating and documenting data discrepancies across Yardi modules (GL, AP, AR, lease administration) and proposing corrections - Documenting queries, reports, data sources, and processes to ensure repeatability and auditability - Supporting user training and responding to internal reporting requests

• Desenvolver, manter e aprimorar dashboards e relatórios em Power BI, assegurando alta qualidade visual, desempenho e confiabilidade das informações disponibilizadas. • Prestar suporte às áreas de negócio na interpretação de indicadores e na utilização das soluções analíticas, promovendo a tomada de decisão orientada por dados. • Elaborar, revisar e otimizar consultas SQL para extração, tratamento e transformação de dados em bancos relacionais e ambientes em nuvem. • Desenvolver scripts em Python para automação de processos, tratamento de dados e análises avançadas. • Apoiar a equipe de Engenharia de Dados nas atividades de ingestão, transformação e disponibilização de dados no Data Lake, atuando nas camadas Bronze, Silver e Gold. • Monitorar a qualidade, integridade e consistência dos dados nas camadas analíticas, identificando, investigando e reportando possíveis inconsistências e anomalias. • Documentar modelos de dados, pipelines de ingestão, processos de transformação e regras de negócio, garantindo rastreabilidade e padronização das informações. • Colaborar com equipes multidisciplinares na identificação de oportunidades de melhoria contínua dos processos de dados e analytics.

• Collect data from multiple sources, whether from databases or via data collection tools; • Data cleaning and preparation: process raw data to ensure it is clean, consistent, and ready for analysis. At this stage, remove any duplicate, corrupted, or blank records that could distort analysis; • Exploratory Data Analysis (EDA): perform exploratory analyses to understand data distributions and identify patterns and/or outliers that may indicate initial trends; • Report and dashboard development: create visual reports and dashboards using Certsys tools and/or client-provided tools that highlight key insights identified during collection, cleaning, and EDA; • Data modeling: actively participate in designing data models and database structures that support the organization’s analytical needs; • Statistical analysis: apply basic statistical techniques to understand relationships between variables, perform hypothesis testing, and conduct comparative analyses based on business rules; • Team collaboration: work with business teams, data scientists, and other professionals to gather analytical requirements and translate them into solutions; • Understanding business objectives: maintain a solid understanding of the organization’s business goals to ensure data analysis is aligned with company objectives; • Technical skill development: continuously improve technical skills, including programming languages such as SQL, Python, or R, and the latest data analysis tools; • Communication of results: effectively communicate data analysis results to technical and non-technical stakeholders, ensuring insights are actionable and can influence business decisions; • Identify opportunities to improve business processes based on data analysis findings.