Job Highlights:
- Competitive Compensation: Attractive salary and benefits package
- Job Title: Care Review Processor (PST Time Zone)
- Location: Remote work opportunity
- Company: Molina Healthcare Services (HCS)
- Start Date: Immediate openings available
Job Summary:
Molina Healthcare Services (HCS) is seeking a skilled Care Review Processor to join our team. As a Care Review Processor, you will play a vital role in assessing, facilitating, planning, and coordinating integrated care delivery for members with high need potential. You will work collaboratively with members, providers, and multidisciplinary team members to ensure patients receive quality, medically appropriate, and cost-effective care.
Key Responsibilities:
- Provide exceptional telephone, clerical, and data entry support for the Care Review team
- Accurately enter authorization requests, provider inquiries, and other relevant information into our computer system
- Respond to requests for authorization of services via phone, fax, and mail within established operational timeframes
- Communicate effectively with physician offices to request missing information or clarify authorization requests
Requirements:
- High School Diploma or GED required; Associate degree preferred
- 1-3 years of experience in an administrative support role in healthcare; 3+ years of experience preferred
- Medical terminology, ICD-10 code knowledge, and CPT code knowledge required
- IPA or health plan UM experience (prior authorization or inpatient) required
What We Offer:
- Competitive benefits and compensation package
- Opportunity to work with a friendly and dynamic team
- Remote work opportunity with flexible scheduling
- Professional growth and development opportunities
We Encourage You to Apply!
Even if you don't feel like a perfect match, we'd still love to hear from you. We're looking for talented and motivated individuals to join our team. Apply now and take the first step towards a rewarding career with Molina Healthcare Services.
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