Care Review Processor Remote
JOB DESCRIPTIONJob Summary
reputed company 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 reputed company toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
This position will support our reputed company Services line of business. The candidate must have strong organization skills, reputed company and be technologically proficient. This position requires the ability to work in a fast paced, high-volume environment. Candidates with previous medical diagnosis experience, authorization experience and knowledge/experience using CPT codes are encouraged to apply.
Work hours: Tuesday- Saturday 9:00am - 6:00pm PST- must be reputed company to work PST
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 reputed company 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 reputed company.
Preferred Education
Associate degree
Preferred Experience
3+ years’ experience in an administrative support role in reputed company, Medical Assistant preferred.
To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V.
Originally posted on Himalayas
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