Long Beach, CA · On-site
$20.34 - $30.39/hr
Essential Job Duties Provides telephone, clerical and data entry support for the care review team ... processing of clinical correspondence. Ability to work effectively in a fast-paced, high-volume ...
New
Long Beach, CA · On-site
$20.34 - $30.39/hr
Essential Job Duties Provides telephone, clerical and data entry support for the care review team ... processing of clinical correspondence. Ability to work effectively in a fast-paced, high-volume ...
New
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
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 ...
Houston, TX · On-site
Remote Care Review Processor Houston, Texas, United States Or refer someone About the Job Remote Care Review Processor Retuurn Solutions works with members, providers and multidisciplinary team ...
Houston, TX · On-site
Remote Care Review Processor Houston, Texas, United States Or refer someone About the Job Remote Care Review Processor Retuurn Solutions works with members, providers and multidisciplinary team ...
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 ...
... • Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan. • Screens members using Molina policies and processes assisting ...
... • Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan. • Screens members using Molina policies and processes assisting ...
Spokane, WA · On-site
... process through claim review, medical record review and research. To provide expert knowledge in ... care, emergency medicine, surgical, pediatrics, advanced practice nursing, and billing and coding ...
Spokane, WA · On-site
... process through claim review, medical record review and research. To provide expert knowledge in ... care, emergency medicine, surgical, pediatrics, advanced practice nursing, and billing and coding ...
... process through claim review, medical record review and research. * To provide expert knowledge in ... Identifies and reports quality of care issues to the Quality Management Department. * Reports ...
... process through claim review, medical record review and research. * To provide expert knowledge in ... Identifies and reports quality of care issues to the Quality Management Department. * Reports ...
Troy, MI · On-site
Follow members from admission process all the way through to discharge, find discharge plan and ... IT Life Sciences Allied Healthcare CRO DIRECT # - 732-844-8726
Troy, MI · On-site
Follow members from admission process all the way through to discharge, find discharge plan and ... IT Life Sciences Allied Healthcare CRO DIRECT # - 732-844-8726
Jacksonville, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Jacksonville, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Miami, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Miami, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Saint Petersburg, FL · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Saint Petersburg, FL · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Saint Petersburg, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Saint Petersburg, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Orlando, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Orlando, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Long Beach, CA · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Long Beach, CA · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Tampa, FL · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Tampa, FL · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Orlando, FL · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Orlando, FL · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Jacksonville, FL · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Jacksonville, FL · On-site
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Long Beach, CA · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Long Beach, CA · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Tampa, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
Tampa, FL · On-site
$26.41 - $51.49/hr
Must live in Florida Job Summary Provides support for member clinical review processes specific to ... Works collaboratively with the utilization and care management departments to provide ABA and ...
$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
| Aspect | Freelance Care Review Processor | Freelance Medical Claims Reviewer |
|---|---|---|
| Credentials | Typically requires healthcare knowledge, certification in medical coding or review | Requires medical billing/coding certification, healthcare background |
| Work Environment | Remote, flexible hours, project-based | Remote, often part-time or freelance, industry-specific |
| Employer & Industry | Healthcare companies, insurance firms, telehealth services | Insurance companies, healthcare providers, third-party administrators |
| Search & Comparison Intent | Understanding review roles in healthcare, freelance review jobs | Comparing medical claims review roles, freelance healthcare jobs |
Both roles involve healthcare review tasks and require relevant certifications. The main difference lies in their focus: Care Review Processors evaluate patient care plans, while Medical Claims Reviewers assess insurance claims for accuracy and compliance. Both jobs are remote, flexible, and industry-specific, catering to healthcare professionals seeking freelance opportunities.
$20.34 - $30.39/hr
Full-time
Posted yesterday
New
8.0
Based on 198 frontline employees who took The Breakroom Quiz
164th of 303 rated insurance
JOB DESCRIPTION Job SummaryProvides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
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 operational timeframes.
Contacts physician offices according to department guidelines to request missing information from authorization requests or for additional information as requested medical directors.
Required Qualifications
At least 1 year of experience in an administrative support role, preferably within a health care environment supporting correspondence or clinical communications, or equivalent combination of relevant education and experience.
Strong attention to detail, and ability to work within regulatory and internal requirements for letter generation.
Strong organizational and time-management skills, and ability to manage multiple letter queues and deadlines.
Excellent verbal and written communication skills, and ability to ensure clarity and precision in all correspondence.
Willingness to learn and adapt to new programs, software systems, and lines of business.
Ability to research, obtain feedback, and integrate necessary adjustments into letters to meet quality standards.
Ability to manage multiple tasks simultaneously, and ensure quality and compliance in all produced correspondence.
Ability to maintain confidentiality and ensure compliance with all relevant guidelines, regulations, and policies in processing of clinical correspondence.
Ability to work effectively in a fast-paced, high-volume environment, maintain accuracy and meet deadlines.
Ability to collaborate effectively with team members and internal departments.
Basic Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
Previous experience in a health care correspondence or clinical communications role, with an understanding of regulatory and accreditation rules related to clinical determinations.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $20.34 - $30.39 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Health care and social assistance
10,000+ Employees
Long Beach, CA, US
1980
