Care Review Processor
El Paso, TX · On-site
Care Review Processor Duration: 4+ months contract Location: Texas USA 79902 Hours: Mon- Fri 8:00 AM to 5:00 PM Top Three Skill Sets: Customer Service, Computer Skills and medical terminology
Care Review Processor
El Paso, TX · On-site
Care Review Processor Duration: 4+ months contract Location: Texas USA 79902 Hours: Mon- Fri 8:00 AM to 5:00 PM Top Three Skill Sets: Customer Service, Computer Skills and medical terminology
... review for other healthcare services * Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate ...
... review for other healthcare services * Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate ...
Title : Care Review Processor Location : Columbus, OH Duration : 3+ Months Responsibilities : Temp for 90 days, no possibility of going permanent. M-F 8 am to 5 pm, no OT. Building case prior ...
Title : Care Review Processor Location : Columbus, OH Duration : 3+ Months Responsibilities : Temp for 90 days, no possibility of going permanent. M-F 8 am to 5 pm, no OT. Building case prior ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · On-site +1
$25.08 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · On-site +1
$25.08 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
Saint Petersburg, FL · On-site
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
Saint Petersburg, FL · On-site
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
(RN) Remote Care Review Clinician - Utilization Review
Charleston, SC · Remote
$25.08 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent ...
(RN) Remote Care Review Clinician - Utilization Review
Charleston, SC · Remote
$25.08 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · Remote
$25.08 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... Collaborates with multidisciplinary teams to promote the Molina care model. Adheres to utilization ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · Remote
$25.08 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... Collaborates with multidisciplinary teams to promote the Molina care model. Adheres to utilization ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$30.37 - $59.21/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
Long Beach, CA · On-site +1
$30.37 - $59.21/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... Collaborates with multidisciplinary teams to promote the Molina care model. Adheres to utilization ...
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... Collaborates with multidisciplinary teams to promote the Molina care model. Adheres to utilization ...
Care Review Clinician (RN)
Tampa, FL · On-site
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
Tampa, FL · On-site
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... for Molina and its members. • Processes requests within required timelines. • Refers ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
Miami, FL · On-site
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
Miami, FL · On-site
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$30.37 - $59.21/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$30.37 - $59.21/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Clinician (RN)
$26.41 - $51.49/hr
... Molina and its members. Processes requests within required timelines. Refers appropriate cases to ... acute care, inpatient review, prior authorization, managed care, or equivalent combination of ...
Care Review Processor Molina information
See salary details
$8.89 - $10.45
6% of jobs
$10.45 - $12
6% of jobs
$13.34 is the 25th percentile. Wages below this are outliers.
$12 - $13.55
14% of jobs
$13.55 - $15.10
19% of jobs
The median wage is $15.49 / hr.
$15.10 - $16.65
15% of jobs
$16.65 - $18.20
13% of jobs
$18.35 is the 75th percentile. Wages above this are outliers.
$18.20 - $19.76
9% of jobs
$19.76 - $21.31
5% of jobs
$21.31 - $22.86
5% of jobs
$22.86 - $24.41
3% of jobs
$24.41 - $25.96
3% of jobs
$8
$16
$25
How much do care review processor molina jobs pay per hour?
As of Jul 30, 2026, the average hourly pay for care review processor molina in the United States is $16.74, according to ZipRecruiter salary data. Most workers in this role earn between $13.46 and $19.23 per hour, depending on experience, location, and employer.
What is the difference between Care Review Processor Molina vs Care Coordinator Molina?
| Aspect | Care Review Processor Molina | Care Coordinator Molina |
|---|---|---|
| Credentials | Typically requires high school diploma or equivalent; some roles may prefer healthcare-related certifications | Requires similar credentials; often a healthcare or social services background |
| Work Environment | Office setting, reviewing patient files and insurance claims | Office or community setting, coordinating patient care and services |
| Employer & Industry | Health insurance companies, healthcare providers | Healthcare organizations, insurance companies |
Care Review Processors focus on reviewing insurance claims and documentation, while Care Coordinators actively manage patient care plans. Both roles require healthcare knowledge and work in similar environments, but their responsibilities differ in scope and daily tasks.
What are the key skills and qualifications needed to thrive as a Care Review Processor at Molina, and why are they important?
To thrive as a Care Review Processor at Molina, you need a strong knowledge of healthcare terminology, medical coding, and case review procedures, typically supported by experience in healthcare administration or a related field. Familiarity with claims processing systems, electronic health records (EHR), and utilization management software is often required. Attention to detail, organizational skills, and effective communication are critical soft skills for accurately reviewing and documenting care decisions. These competencies ensure timely, compliant, and accurate processing of care reviews, which supports patient care quality and organizational efficiency.
What are Care Review Processors at Molina?
Care Review Processors at Molina are professionals responsible for reviewing and processing healthcare service requests to ensure they meet medical necessity and policy guidelines. They work closely with clinicians, members, and providers to gather necessary documentation and help determine if requested services are covered under a member’s health plan. Their work supports timely and accurate decision-making for authorizations and appeals, helping ensure members receive appropriate care. Typically, this role requires attention to detail, familiarity with medical terminology, and the ability to navigate health plan systems.
What are some common challenges faced by Care Review Processors at Molina, and how can applicants prepare to handle them?
Care Review Processors at Molina often navigate complex medical documentation and must ensure timely, accurate evaluations of care requests. Common challenges include managing a high volume of cases while meeting strict regulatory timelines and maintaining clear communication with providers and internal teams. Applicants can prepare by familiarizing themselves with medical terminology, developing strong organizational skills, and staying current with healthcare compliance standards. Proactive time management and attention to detail are key to success in this fast-paced environment.
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What cities are hiring for Care Review Processor Molina jobs? Cities with the most Care Review Processor Molina job openings:
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Job description
Job Description
Job Title: Care Review Processor
Duration: 4+ months contract
Location: Texas USA 79902
Hours: Mon- Fri 8:00 AM to 5:00 PM
Top Three Skill Sets: Customer Service, Computer Skills and medical terminology
Job Description:
- Provide computer entries of authorization request/provider inquiries by phone, mail, or fax. Including: Verify member eligibility and benefits, Determine provider contracting status and appropriateness, Determine diagnosis and treatment request Assign billing codes (ICD-9/ICD-10 and/or CPT/HCPC codes), Determine COB status, Verify inpatient hospital census-admits and discharges, Perform action required per protocol using the appropriate Database.
- Respond to requests for authorization of services submitted to CAM via phone, fax and mail according to Client's operational timeframes.
- Participates in interdepartmental integration and collaboration to enhance the continuity of care for Client members including Behavioral Health and Long Term Care.
- Contact physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.
- Provide excellent customer service for internal and external customers.
- Meet department quality standards, including inter-rater reliability (IRR) testing and quality review audit scores.
- Notify Care Access and Monitoring Nurses and case managers of hospital admissions and changes in member status.
- Meet productivity standards.
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
EDUCATION:
- Accurate data entry at 40 WPM minimum.
- Required Education: High School Diploma/GED
- Required Experience: 1-4 years of experience in a Utilization Review Department in a Managed Care Environment.
- Previous Hospital or Healthcare clerical, audit or billing experience. Experience with Medical Terminology
Additional Information
All your information will be kept confidential according to EEO guidelines.
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996