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Summary:
Molina Healthcare Services (HCS) is hiring a Care Review Processor to provide telephone, clerical, and data entry support for the Care Review team. This remote role involves managing authorization requests, verifying eligibility, and coordinating care for members. The position requires 1-3 years of administrative support experience in healthcare and operates on a 10AM – 7PM PST shift.
Responsibilities:
- Provides telephone, clerical, and data entry support for the Care Review team.
- Enters authorization requests and provider inquiries into the system, including eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits status determination, hospital census information regarding admissions and discharges, and billing codes.
- Responds to requests for authorization of services submitted via phone, fax, and mail according to Molina operational timeframes.
- Contacts physician offices to request missing information from authorization requests or for additional information as requested by the Medical Director.
Requirements:
- Required Education: HS Diploma or GED.
- Required Experience: 1-3 years’ experience in an administrative support role in healthcare.
- Preferred Education: Associate degree.
- Preferred Experience: 3+ years’ experience in an administrative support role in healthcare, Medical Assistant preferred.
- Must work 10AM – 7PM PST shift.
- Remote work setting.
Benefits:
- Health insurance.
- Competitive benefits and compensation package.
