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Slp Remote Insurance Review Jobs in California (NOW HIRING)

Corvel

Professional Review Nurse

Folsom, CA · Remote

$70K - $85K/yr

This is a remote position in CA. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identify the necessity ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

Molina Healthcare

Care Review Clinician (RN)

Long Beach, CA · On-site +1

$23.76 - $51.49/hr

The position is fully remote. Excellent computer skills and attention to detail are very important ... insurance policies, and regulations - ensuring members reach desired outcomes through integrated ...

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Slp Remote Insurance Review information

What is an SLP Remote Insurance Review?

An SLP Remote Insurance Review is a process in which a licensed Speech-Language Pathologist (SLP) reviews patient documentation and insurance information remotely—often from home—to determine coverage for speech therapy services. This role involves evaluating medical records, verifying insurance benefits, and ensuring that therapy services meet the necessary criteria for reimbursement. SLPs in this position may also communicate with insurance companies and healthcare providers to clarify requirements or resolve issues. This work supports both patients and providers by helping to streamline the approval process for necessary therapy.

What are the key skills and qualifications needed to thrive as an SLP Remote Insurance Review Specialist, and why are they important?

To thrive as an SLP Remote Insurance Review Specialist, you need a valid Speech-Language Pathology (SLP) license, in-depth knowledge of clinical documentation, and understanding of insurance and reimbursement processes. Familiarity with electronic health records (EHR), insurance portals, and medical billing software is commonly required. Outstanding attention to detail, analytical thinking, and effective written communication are vital soft skills for reviewing records and interacting with providers or payers. These skills ensure accurate claim reviews, compliance, and efficient authorization processes critical for timely patient care and reimbursement.

What are some common challenges faced by SLPs performing remote insurance reviews, and how can they be managed?

SLPs conducting remote insurance reviews often encounter challenges such as navigating complex insurance policies, ensuring timely documentation, and effectively communicating with insurance representatives and clients. Staying organized with electronic health records and maintaining up-to-date knowledge of coverage criteria can help manage these challenges. Additionally, clear and professional communication, both written and verbal, is essential for advocating for clients and resolving potential coverage disputes.

What is the difference between Slp Remote Insurance Review vs Speech-Language Pathologist?

AspectSlp Remote Insurance ReviewSpeech-Language Pathologist
CredentialsTypically requires background in insurance or healthcare billing, not necessarily SLP certificationRequires state licensure and CCC-SLP certification
Work EnvironmentRemote, administrative setting focused on insurance claims and reviewsClinical, healthcare setting or private practice providing therapy services
Employer & IndustryInsurance companies, healthcare billing firmsHospitals, clinics, schools, private practices

While Slp Remote Insurance Review involves evaluating insurance claims related to speech therapy, Speech-Language Pathologists provide direct therapy services to clients. The former is more administrative and insurance-focused, often remote, whereas the latter is clinical and patient-facing.

What are popular job titles related to Slp Remote Insurance Review jobs in California? For Slp Remote Insurance Review jobs in California, the most frequently searched job titles are:
What job categories do people searching Slp Remote Insurance Review jobs in California look for? The top searched job categories for Slp Remote Insurance Review jobs in California are:
What cities in California are hiring for Slp Remote Insurance Review jobs? Cities in California with the most Slp Remote Insurance Review job openings:
Slp Remote Insurance Review jobs near you
Infographic showing various Slp Remote Insurance Review job openings in California as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Care Review Clinician (RN) Remote

Molina Healthcare

Long Beach, CA • On-site, Remote

$26.41 - $51.49/hr

Full-time

Posted 28 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 197 frontline employees who took The Breakroom Quiz

161st of 300 rated insurance

Job description


JOB DESCRIPTION
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been admitted to this hospital. The Medicaid will support them to ensure a successful transition from inpatient to discharge to either a nursing facility or back to their home. The position is a combination of phone call outreach and in person meetings with the members while still inpatient. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes.
This is a telephonic remote position and productivity is important. Preferred candidates will have previous utilization management, case management, managed care, or inpatient hospital experience. Experience in a behavioral health setting would be a plus.
Schedule: Monday through Friday 8:00AM to 5:00PM EST 8 hours (Weekends, no nights, no call.)
Job Summary
Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
• Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
• Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
• Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
• Processes requests within required timelines.
• Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
• Requests additional information from members or providers as needed.
• Makes appropriate referrals to other clinical programs.
• Collaborates with multidisciplinary teams to promote the Molina care model.
• Adheres to utilization management (UM) policies and procedures.
Required Qualifications
• At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational, problem-solving and critical-thinking skills.
• Strong written and verbal communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Certified Professional in Healthcare Management (CPHM).
• Recent hospital experience in an intensive care unit (ICU) or emergency room.
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

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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

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