Care Review Processor (Remote)
Lensa
Date: 2 weeks ago
City: Albuquerque, 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
Warehouse II
White Cap,
Albuquerque, NM
4 hours ago
A position at White Cap isn’t your ordinary job. You’ll work in an exciting and diverse environment, meet interesting people, and have a variety of career opportunities.The White Cap family is committed to Building Trust on Every Job. We do this by being deeply knowledgeable, fully capable, and always dependable, and our associates are the driving force behind this commitment.White...
Team Member
Einstein Bros Bagels,
Albuquerque, NM
2 days ago
Brand: Einstein Bros. BagelsBreakfast with us, and dinner with your loved ones! At Einstein Bros. Bagels, we believe in the bagel, and we’ve been baking bagels fresh daily since 1995. We believe that our bakeries do more than just make the best breakfast in the neighborhood. We guarantee two things: First, to spread a little more joy and happiness in...
Jr Systems Administrator
Adelante Development Center, Inc.,
Albuquerque, NM
2 weeks ago
Job DetailsDescription$1250 Hiring Bonus!!!Join our team of I.T professional's who help to move our community forward! The Jr Systems Administrator is an essential member of the team that provides support to keep our I.T department up and running. We offer paid training, a great benefit package including paid holidays, generous PTO and so much more!The Jr Systems Administrator will keep...
