Care Review Processor (PST or CST Hours)

Molina Healthcare • Tacoma, WA • 6h ago

Molina Healthcare is hiring several Care Review Processors. These roles are remote and can be worked in a variety of states within the US.

Highly qualified candidates will have the following:

Healthcare knowledge or background either clinical (Medical Assistant) or in an administrative capacity

Experience working in a fast paced, high-volume environment with priorities that may change

High level critical thinking skills

Above average computer skills

Adaptability and attention to detail

Ability to work either 830am-530 pm Monday through Friday or Tuesday through Saturday.

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.

Required Education : HS Diploma or GED

Preferred Education : Associate Degree

Required Experience : 1-3 years' experience in an administrative support role in healthcare.

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 competitive benefits and compensation packages. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Same Posting Description for Internal and External Candidates

Pay Range: $21.16 - $31.71 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Similar Jobs

Helath Informatin Technician

Robert Half • Seatac, WA • 1h ago

IT & Engineering

Description We are looking for a detail-oriented Medical Records Technician to join our team in SeaTac, Washington. In this Contract-to-Permanent position, you will play a vital role in ensuring the accuracy and accessib...

1h ago

Go to Apply

Seasonal Package Delivery Driver

UPS • Tacoma, WA • 1h ago

Retail & Hospitality

Casual Package Delivery Driver Who exactly are UPS Casual Package Delivery Drivers? They're the ones who drive our familiar brown trucks, bringing packages great and small to our customers. They're a friendly, physically...

1h ago

Go to Apply

Health Information Technician

Robert Half • Seatac, WA • 2h ago

Hospital & Medical

Description We are looking for a detail-oriented and customer-service-focused Medical Records Clerk to to support our Health Information Management (HIM) department in SeaTac, Washington. This Contract-to-Permanent posit...

2h ago

Go to Apply

Strategic Enterprise Account Executive-1

Comcast • Puyallup, WA • 5h ago

Sales & Marketing

Comcast brings together the best in media and technology. We drive innovation to create the world's best entertainment and online experiences. As a Fortune 50 leader, we set the pace in a variety of innovative and fascin...

5h ago

Go to Apply

Oncology Clinic Patient Account Rep

Virginia Mason Franciscan Health • Tacoma, WA • 5h ago

Hospital & Medical

Responsibilities JOB SUMMARY: Performs a variety of administrative support duties associated with the patient intake process in accordance with established internal guidelines and procedures. Work includes 1) scheduling...

5h ago

Go to Apply

Care Connections Member Advocate Representative - Must Be Bilingual in (Spanish, Cantonese, Russian, Tagalog) - Pacific Time Zone Hours

Molina Healthcare • Tacoma, WA • 6h ago

Retail & Hospitality

Job Description Job Summary Makes outbound calls to members, completes assigned hand-dial lists, and provides proactive member support, information, and assistance. Adheres to member interaction departmental standards, c...

6h ago

Go to Apply

Medical Assistant

Virginia Mason Franciscan Health • Enumclaw, WA • 9h ago

Hospital & Medical

Responsibilities Sign on Bonus for qualifying new external Certified Medical Assistants available! Franciscan Medical Group, as part of Virginia Mason Franciscan Health, is currently seeking a full- time Clinic Medical A...

9h ago

Go to Apply

Medical Assistant

Virginia Mason Franciscan Health • Enumclaw, WA • 9h ago

Hospital & Medical

9h ago

Go to Apply

Medical Assistant

Virginia Mason Franciscan Health • Milton, WA • 9h ago

Hospital & Medical

9h ago

Go to Apply

737 Interiors Certification Engineer (Mid-Level or Senior)

The Boeing Company • Renton, WA • 12h ago

IT & Engineering

Job Description At Boeing, we innovate and collaborate to make the world a better place. We're committed to fostering an environment for every teammate that's welcoming, respectful and inclusive, with great opportunity f...

12h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.