Care Review Processor - Military Veterans
at Molina Healthcare
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.
Job Qualifications
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: $12.19 - $26.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Louisville, KY
Molina believes every person, family and community deserves access to high-quality health care regardless of their situation. Our mission is to deliver effective, reliable and affordable health care to those who need it most. We strive to meet the physical, social and emotional needs of each member and to strengthen the communities we serve.
We do this by offering a holistic, community-based approach designed specifically to meet the individual needs of our members.
What started in 1980 as one clinic in Long Beach, aimed at addressing the disparities in access to quality health care, has grown into 19 health plans across the country. For over 40-years we’ve been improving the lives of our 5.1 million members across the country by pioneering health care services exclusively for those with government-sponsored health care.
As our membership has grown over the years, so has our commitment to the communities we serve. In 2020, we launched the MolinaCares Accord, which makes substantial investments to improve members’ access to health care.