Care Review Processor (Working 10AM - 7PM PST Shift) - REMOTE
Molina Healthcare Arizona; Spokane, Washington; Florida; Green Bay, Wisconsin; Madison, Wisconsin; Macon, Georgia; Cedar Rapids, Iowa; Davenport, Iowa; Owensboro, Kentucky; Covington, Kentucky; Nebraska; Roswell, New Mexico; New Mexico; Rochester, New York; Akron, Ohio; Texas; Seattle, Washington; Jacksonville, Florida; Kenosha, Wisconsin; Atlanta, Georgia; Sioux City, Iowa; Meridian, Idaho; Grand Rapids, Michigan; New York, New York; Utah; Orem, Utah; Vancouver, Washington; Tampa, Florida; Miami, Florida; Georgia; Kentucky; Ann Arbor, Michigan; Michigan; Santa Fe, New Mexico; Las Cruces, New Mexico; Yonkers, New York; Ohio; Houston, Texas; Scottsdale, Arizona; Chandler, Arizona; Tucson, Arizona; Iowa City, Iowa; Idaho Falls, Idaho; Bowling Green, Kentucky; Kearney, Nebraska; Omaha, Nebraska; Grand Island, Nebraska; Albuquerque, New Mexico; Rio Rancho, New Mexico; Columbus, Ohio; Cleveland, Ohio; Fort Worth, Texas; San Antonio, Texas; West Valley City, Utah; Tacoma, Washington; Racine, Wisconsin; Wisconsin; Idaho; Warren, Michigan; Detroit, Michigan; Lincoln, Nebraska; Bellevue, Nebraska; Cincinnati, Ohio; Washington; Bellevue, Washington; Phoenix, Arizona; Orlando, Florida; St. Petersburg, Florida; Columbus, Georgia; Savannah, Georgia; Des Moines, Iowa; Iowa; Nampa, Idaho; Sterling Heights, Michigan; Syracuse, New York; Buffalo, New York; Provo, Utah; Boise, Idaho; Caldwell, Idaho; Dayton, Ohio; Dallas, Texas; Mesa, Arizona; Milwaukee, Wisconsin; Augusta, Georgia; Lexington-Fayette, Kentucky; Louisville, Kentucky; New York; Austin, Texas; Layton, Utah; Salt Lake City, Utah Job ID 2030613JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
KNOWLEDGE/SKILLS/ABILITIES
- Provides telephone, clerical, and data entry support for the Care Review team.
- Provides computer entries of authorization request/provider inquiries, such as 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 according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.
Job Qualifications
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.
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.
Pay Range: $21.16 - $31.71 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 03/12/2025ABOUT OUR LOCATION
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- Care Review Processor (Working 10AM - 7PM PST Shift) - REMOTE Arizona, Spokane Washington, Florida, Green Bay Wisconsin, Madison Wisconsin, Macon Georgia, Cedar Rapids Iowa, Davenport Iowa, Owensboro Kentucky, Covington Kentucky, Nebraska, Roswell New Mexico, New Mexico, Rochester New York, Akron Ohio, Texas, Seattle Washington, Jacksonville Florida, Kenosha Wisconsin, Atlanta Georgia, Sioux City Iowa, Meridian Idaho, Grand Rapids Michigan, New York New York, Utah, Orem Utah, Vancouver Washington, Tampa Florida, Miami Florida, Georgia, Kentucky, Ann Arbor Michigan, Michigan, Santa Fe New Mexico, Las Cruces New Mexico, Yonkers New York, Ohio, Houston Texas, Scottsdale Arizona, Chandler Arizona, Tucson Arizona, Iowa City Iowa, Idaho Falls Idaho, Bowling Green Kentucky, Kearney Nebraska, Omaha Nebraska, Grand Island Nebraska, Albuquerque New Mexico, Rio Rancho New Mexico, Columbus Ohio, Cleveland Ohio, Fort Worth Texas, San Antonio Texas, West Valley City Utah, Tacoma Washington, Racine Wisconsin, Wisconsin, Idaho, Warren Michigan, Detroit Michigan, Lincoln Nebraska, Bellevue Nebraska, Cincinnati Ohio, Washington, Bellevue Washington, Phoenix Arizona, Orlando Florida, St. Petersburg Florida, Columbus Georgia, Savannah Georgia, Des Moines Iowa, Iowa, Nampa Idaho, Sterling Heights Michigan, Syracuse New York, Buffalo New York, Provo Utah, Boise Idaho, Caldwell Idaho, Dayton Ohio, Dallas Texas, Mesa Arizona, Milwaukee Wisconsin, Augusta Georgia, Lexington-Fayette Kentucky, Louisville Kentucky, New York, Austin Texas, Layton Utah, Salt Lake City Utah 03/12/2025
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