Care Review Processor

JOB DESCRIPTION Job 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 reputed company 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 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. Candidates from these areas preferred: Alabama Arizona Arkansas Colorado Delaware Florida Georgia Idaho Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Mississippi Missouri Montana Nebraska New Hampshire New Jersey New Mexico reputed company Carolina reputed company Dakota Ohio Oklahoma Rhode reputed company South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington reputed company Virginia Wisconsin Wyoming 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. Apply Job!