Care Review Processor - Remote (PST hours)

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Job DescriptionSchedule: Mon-Fri, 8 hour shift. Available shifts: 8am-5pm PST, 9am-6pm PST, 10am-7pm PSTJob 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 QualificationsRequired 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.

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