Essential Job Duties • Provides telephone, clerical and data entry support for the care review ... information from authorization requests or for additional information as requested medical ...
Essential Job Duties • Provides telephone, clerical and data entry support for the care review ... information from authorization requests or for additional information as requested medical ...
Document Review Processor (French Bilingual)
Baton Rouge, LA · On-site
$20 - $22/hr
Remote / Work from Home in the US #LI-Remote Work Hours: Monday - Friday 8am - 430pm CST Short ... review, translate and process client documentation. * 1+ years of experience in a general office ...
Document Review Processor (French Bilingual)
Baton Rouge, LA · On-site
$20 - $22/hr
Remote / Work from Home in the US #LI-Remote Work Hours: Monday - Friday 8am - 430pm CST Short ... review, translate and process client documentation. * 1+ years of experience in a general office ...
Home Care Administrator
Beaver Falls, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Beaver Falls, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Wilmington, DE · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Wilmington, DE · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Care Review Clinician, ABA
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... requests from members/providers against evidence based clinical guidelines. • Identifies ...
Care Review Clinician, ABA
$26.41 - $51.49/hr
Job Summary Provides support for member clinical review processes specific to applied behavioral ... requests from members/providers against evidence based clinical guidelines. • Identifies ...
Responsible for carrying out medical necessity reviews on all designated referrals for Home Care ... Understands the Complex Case Management Program and referral process; Refers patients to the ...
Responsible for carrying out medical necessity reviews on all designated referrals for Home Care ... Understands the Complex Case Management Program and referral process; Refers patients to the ...
Foster Care Review Board's primary role is to advise the juvenile court by reviewing cases of children under court jurisdiction in out-of-home placement. Each case is reviewed at least every six ...
Foster Care Review Board's primary role is to advise the juvenile court by reviewing cases of children under court jurisdiction in out-of-home placement. Each case is reviewed at least every six ...
Home Care Administrator
Scranton, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Scranton, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Care Review Clinician II
Troy, MI · On-site
Transferring from inpatient to nursing facility. They will be completing nursing facility reviews. Looking for medical necessity to determine what level of nursing facility care they will need. This ...
Care Review Clinician II
Troy, MI · On-site
Transferring from inpatient to nursing facility. They will be completing nursing facility reviews. Looking for medical necessity to determine what level of nursing facility care they will need. This ...
Home Care Administrator
Reading, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Reading, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Upper Darby, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Upper Darby, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Lancaster, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Lancaster, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Philadelphia, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Philadelphia, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Pittsburgh, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Administrator
Pittsburgh, PA · On-site
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Promptly prepare documentation from home visits, submit to CA State Level-of-Care (LOC) nurse for review and reply to questions to expedite the review process for participants * Track and oversee the ...
Promptly prepare documentation from home visits, submit to CA State Level-of-Care (LOC) nurse for review and reply to questions to expedite the review process for participants * Track and oversee the ...
Home Care Aide
Glendora, CA · On-site
$18 - $22/hr
Home Care Aide (HCA) registration -if not already registered, we'll assist with the process * At ... from medical procedures. Our care philosophy is based on finding interesting, innovative ways to ...
Home Care Aide
Glendora, CA · On-site
$18 - $22/hr
Home Care Aide (HCA) registration -if not already registered, we'll assist with the process * At ... from medical procedures. Our care philosophy is based on finding interesting, innovative ways to ...
Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. * Oversees and investigates patient and physician concerns, risk management concerns and ...
Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. * Oversees and investigates patient and physician concerns, risk management concerns and ...
We Welcome Applicants From Many Backgrounds We encourage applications from: * Experienced ... Applications are reviewed daily, and interviews are currently being scheduled.
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We Welcome Applicants From Many Backgrounds We encourage applications from: * Experienced ... Applications are reviewed daily, and interviews are currently being scheduled.
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Review assessment reports for all departments and implement opportunities for process improvements ... Reviewing the Enterprise Incident Management reports and incidents from the prior week. * Review ...
Home Care Scheduler
$47K - $53K/yr
... from you. About Griswold Home Care For over 40 years, Griswold has been dedicated to helping ... Manage billing and payroll processes on a weekly basis. * Perform client assessments to understand ...
Home Care Scheduler
$47K - $53K/yr
... from you. About Griswold Home Care For over 40 years, Griswold has been dedicated to helping ... Manage billing and payroll processes on a weekly basis. * Perform client assessments to understand ...
From Home Care Review Processor 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
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$14 - $26.42/hr
Full-time
Posted 16 days ago
Molina Healthcare rating
8.0
Based on 199 frontline employees who took The Breakroom Quiz
171st of 315 rated insurance
Job description
JOB DESCRIPTION
Job Summary
Provides 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.
• Previous experience as a Correspondence Processor at Molina.
• 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: $14 - $26.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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About Molina Healthcare
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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.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Long Beach, CA, US
Year founded
1980