Care Review Processor (Remote) - #254779
Lensa
Date: 1 week ago
City: Las Cruces, NM
Contract type: Full time
Remote
Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!
Job 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
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
Job 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.
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.
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Mechanical Engineer I/II/III
Sierra Lobo, Inc.,
Las Cruces, NM
8 hours ago
Overview Sierra Lobo, offers customers a full range of professional and technical capabilities, including Test and Evaluation, Systems Engineering, and Advanced Technologies. We also develop products and processes related to Cryogenic Fluid and Thermal Management Systems, Densified Propellant Management Systems, and Prototype Extreme Pressure and Temperature Systems. Our customers include the Department of Defense (DoD), the U.S. Air Force, U.S....
Electrical Engineer 1/2
Sierra Lobo, Inc.,
Las Cruces, NM
8 hours ago
Overview Sierra Lobo, offers customers a full range of professional and technical capabilities, including Test and Evaluation, Systems Engineering, and Advanced Technologies. We also develop products and processes related to Cryogenic Fluid and Thermal Management Systems, Densified Propellant Management Systems, and Prototype Extreme Pressure and Temperature Systems. Our customers include the Department of Defense (DoD), the U.S. Air Force, U.S....
Accounts Receivable Bookkeeper
Genesis,
Las Cruces, NM
$17
-
$20
per hour
1 week ago
Overview At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference. Whether you're an experienced professional or...
