Care Review Processor
Molina Healthcare Arizona; Las Cruces, New Mexico; Rochester, New York; Yonkers, New York; Provo, Utah; Milwaukee, Wisconsin; Phoenix, Arizona; Chandler, Arizona; Nampa, Idaho; Iowa City, Iowa; Detroit, Michigan; Grand Island, Nebraska; Akron, Ohio; Salt Lake City, Utah; Seattle, Washington; Davenport, Iowa; Louisville, Kentucky; Grand Rapids, Michigan; Ann Arbor, Michigan; Buffalo, New York; Nebraska; Utah; Wisconsin; Austin, Texas; Tacoma, Washington; Miami, Florida; Boise, Idaho; Caldwell, Idaho; Cedar Rapids, Iowa; Bowling Green, Kentucky; Owensboro, Kentucky; Omaha, Nebraska; Santa Fe, New Mexico; Georgia; Columbus, Ohio; Cleveland, Ohio; New York; Texas; Ohio; Kenosha, Wisconsin; Columbus, Georgia; Meridian, Idaho; Kearney, Nebraska; Rio Rancho, New Mexico; Roswell, New Mexico; Idaho; New York, New York; Syracuse, New York; Dayton, Ohio; San Antonio, Texas; Dallas, Texas; Washington; Fort Worth, Texas; West Valley City, Utah; Bellevue, Washington; Mesa, Arizona; Orlando, Florida; St. Petersburg, Florida; Des Moines, Iowa; Lexington-Fayette, Kentucky; Sterling Heights, Michigan; Iowa; New Mexico; Spokane, Washington; Madison, Wisconsin; Racine, Wisconsin; Tucson, Arizona; Scottsdale, Arizona; Savannah, Georgia; Covington, Kentucky; Albuquerque, New Mexico; Michigan; Cincinnati, Ohio; Orem, Utah; Vancouver, Washington; Tampa, Florida; Augusta, Georgia; Idaho Falls, Idaho; Sioux City, Iowa; Lincoln, Nebraska; Bellevue, Nebraska; Florida; Kentucky; Houston, Texas; Layton, Utah; Green Bay, Wisconsin; Jacksonville, Florida; Atlanta, Georgia; Macon, Georgia; Warren, Michigan Job ID 2029715JOB 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: $20.29 - $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: 01/09/2025ABOUT OUR LOCATION
View Map- Analyst, Healthcare Analytics Arizona, Augusta Georgia, Savannah Georgia, Cedar Rapids Iowa, Nebraska, Detroit Michigan, Warren Michigan, Ann Arbor Michigan, Utah, Bellevue Nebraska, Kearney Nebraska, Santa Fe New Mexico, Houston Texas, Atlanta Georgia, Columbus Georgia, Macon Georgia, Boise Idaho, Davenport Iowa, Iowa, Michigan, Grand Rapids Michigan, New Mexico, Wisconsin, Cincinnati Ohio, Fort Worth Texas, Scottsdale Arizona, Kentucky, Owensboro Kentucky, Texas, Las Cruces New Mexico, Yonkers New York, Columbus Ohio, Dallas Texas, Orem Utah, Bellevue Washington, Madison Wisconsin, Green Bay Wisconsin, Tucson Arizona, Mesa Arizona, Meridian Idaho, Iowa City Iowa, Louisville Kentucky, Lexington-Fayette Kentucky, West Valley City Utah, Spokane Washington, Tacoma Washington, Vancouver Washington, Milwaukee Wisconsin, Racine Wisconsin, Orlando Florida, Idaho Falls Idaho, Caldwell Idaho, New York, Grand Island Nebraska, Rio Rancho New Mexico, Akron Ohio, Provo Utah, Seattle Washington, Sioux City Iowa, Georgia, Roswell New Mexico, Dayton Ohio, Phoenix Arizona, Jacksonville Florida, Tampa Florida, St. Petersburg Florida, Bowling Green Kentucky, Idaho, Washington, Omaha Nebraska, Lincoln Nebraska, New York New York, Buffalo New York, Rochester New York, Syracuse New York, San Antonio Texas, Austin Texas, Salt Lake City Utah, Layton Utah, Kenosha Wisconsin, Chandler Arizona, Miami Florida, Nampa Idaho, Des Moines Iowa, Florida, Covington Kentucky, Sterling Heights Michigan, Ohio, Albuquerque New Mexico, Cleveland Ohio 01/08/2025
- Care Review Processor Arizona, Las Cruces New Mexico, Rochester New York, Yonkers New York, Provo Utah, Milwaukee Wisconsin, Phoenix Arizona, Chandler Arizona, Nampa Idaho, Iowa City Iowa, Detroit Michigan, Grand Island Nebraska, Akron Ohio, Salt Lake City Utah, Seattle Washington, Davenport Iowa, Louisville Kentucky, Grand Rapids Michigan, Ann Arbor Michigan, Buffalo New York, Nebraska, Utah, Wisconsin, Austin Texas, Tacoma Washington, Miami Florida, Boise Idaho, Caldwell Idaho, Cedar Rapids Iowa, Bowling Green Kentucky, Owensboro Kentucky, Omaha Nebraska, Santa Fe New Mexico, Georgia, Columbus Ohio, Cleveland Ohio, New York, Texas, Ohio, Kenosha Wisconsin, Columbus Georgia, Meridian Idaho, Kearney Nebraska, Rio Rancho New Mexico, Roswell New Mexico, Idaho, New York New York, Syracuse New York, Dayton Ohio, San Antonio Texas, Dallas Texas, Washington, Fort Worth Texas, West Valley City Utah, Bellevue Washington, Mesa Arizona, Orlando Florida, St. Petersburg Florida, Des Moines Iowa, Lexington-Fayette Kentucky, Sterling Heights Michigan, Iowa, New Mexico, Spokane Washington, Madison Wisconsin, Racine Wisconsin, Tucson Arizona, Scottsdale Arizona, Savannah Georgia, Covington Kentucky, Albuquerque New Mexico, Michigan, Cincinnati Ohio, Orem Utah, Vancouver Washington, Tampa Florida, Augusta Georgia, Idaho Falls Idaho, Sioux City Iowa, Lincoln Nebraska, Bellevue Nebraska, Florida, Kentucky, Houston Texas, Layton Utah, Green Bay Wisconsin, Jacksonville Florida, Atlanta Georgia, Macon Georgia, Warren Michigan 01/09/2025
- Program Manager-Clinical Operations (REMOTE) Arizona, Santa Fe New Mexico, Cincinnati Ohio, Akron Ohio, Fort Worth Texas, West Valley City Utah, Orem Utah, Phoenix Arizona, Tucson Arizona, Scottsdale Arizona, Meridian Idaho, Des Moines Iowa, Sterling Heights Michigan, Lincoln Nebraska, Bellevue Nebraska, New York New York, Columbus Ohio, Cleveland Ohio, Michigan, Texas, Boise Idaho, Omaha Nebraska, Grand Island Nebraska, Rio Rancho New Mexico, Dayton Ohio, Layton Utah, Madison Wisconsin, Kentucky, Chandler Arizona, Jacksonville Florida, Macon Georgia, Bowling Green Kentucky, Grand Rapids Michigan, Buffalo New York, Rochester New York, Yonkers New York, Salt Lake City Utah, Spokane Washington, New York, Wisconsin, St. Petersburg Florida, Idaho Falls Idaho, Davenport Iowa, Syracuse New York, San Antonio Texas, Milwaukee Wisconsin, Racine Wisconsin, Florida, Ohio, Mesa Arizona, Miami Florida, Tampa Florida, Columbus Georgia, Savannah Georgia, Iowa City Iowa, Warren Michigan, Kearney Nebraska, Houston Texas, Tacoma Washington, Bellevue Washington, Green Bay Wisconsin, Kenosha Wisconsin, Iowa, Orlando Florida, Atlanta Georgia, Caldwell Idaho, Cedar Rapids Iowa, Louisville Kentucky, Lexington-Fayette Kentucky, Owensboro Kentucky, Detroit Michigan, Albuquerque New Mexico, Las Cruces New Mexico, Roswell New Mexico, Dallas Texas, Provo Utah, Seattle Washington, Vancouver Washington, Idaho, Nebraska, Utah, Washington, Augusta Georgia, Sioux City Iowa, Ann Arbor Michigan, Austin Texas, Georgia, New Mexico, Nampa Idaho, Covington Kentucky 01/08/2025
- Care Review Processor Arizona, Mesa Arizona, Miami Florida, St. Petersburg Florida, Atlanta Georgia, Macon Georgia, Wisconsin, Nampa Idaho, Cedar Rapids Iowa, Las Cruces New Mexico, Yonkers New York, Salt Lake City Utah, Provo Utah, Madison Wisconsin, Racine Wisconsin, Tucson Arizona, Florida, Caldwell Idaho, Des Moines Iowa, Sioux City Iowa, Syracuse New York, Columbus Ohio, Austin Texas, Spokane Washington, Phoenix Arizona, Scottsdale Arizona, Iowa, Lexington-Fayette Kentucky, Bowling Green Kentucky, Omaha Nebraska, Rio Rancho New Mexico, Buffalo New York, Layton Utah, Bellevue Washington, Milwaukee Wisconsin, New York, Ohio, Ann Arbor Michigan, Santa Fe New Mexico, Roswell New Mexico, West Valley City Utah, Vancouver Washington, Green Bay Wisconsin, Tampa Florida, Kentucky, Michigan, Idaho Falls Idaho, Davenport Iowa, Covington Kentucky, Detroit Michigan, Lincoln Nebraska, Grand Island Nebraska, San Antonio Texas, Orem Utah, Tacoma Washington, Orlando Florida, Utah, Louisville Kentucky, Grand Rapids Michigan, Kearney Nebraska, Rochester New York, Cincinnati Ohio, Dayton Ohio, Fort Worth Texas, Seattle Washington, Georgia, Idaho, Columbus Georgia, Savannah Georgia, Boise Idaho, Albuquerque New Mexico, New York New York, Dallas Texas, Kenosha Wisconsin, Chandler Arizona, Jacksonville Florida, Nebraska, Augusta Georgia, New Mexico, Texas, Washington, Meridian Idaho, Iowa City Iowa, Owensboro Kentucky, Warren Michigan, Sterling Heights Michigan, Bellevue Nebraska, Cleveland Ohio, Akron Ohio, Houston Texas 01/03/2025
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