Care Review ProcessorMolina Healthcare • Nampa, ID, United States
serp_jobs.error_messages.no_longer_accepting
Care Review Processor
Molina Healthcare • Nampa, ID, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_descriptionAt 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. Previous experience in a health care correspondence or clinical communications role, with an understanding of regulatory and accreditation rules related to clinical determinations. Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
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
Preferred Qualifications
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 : $21.16 - $31.71 / HOURLY
serp_jobs.job_alerts.create_a_job
Processor • Nampa, ID, United States
Job_description.internal_linking.related_jobs
Partner with VHS in our mission to elevate healthcare staffing to new heights.Our dedicated locum recruiters are ready to assist with your next assignment, whether temporary or permanent.We take ca...serp_jobs.internal_linking.show_more
Provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance p...serp_jobs.internal_linking.show_more
NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more
NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clini...serp_jobs.internal_linking.show_more 
NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more 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, inc...serp_jobs.internal_linking.show_more 
RN Health Care Facility Surveyor - Remote (#1149).Company-issued and company-paid Amex card for travel.All travel expenses paid directly by the company.
Airline and hotel points accumulate for emplo...serp_jobs.internal_linking.show_more NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more Provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance p...serp_jobs.internal_linking.show_more NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more 
We are seeking a CRNA for a locum coverage in Idaho.ID, CDS and DEA license required.We provide excellent weekly compensation, cover all travel expenses, provide A+ rated malpractice Insu...serp_jobs.internal_linking.show_more NO EXPERIENCE REQUIRED – PAID TRAINING PROVIDED – JOB SECURITY.The Postal Service is the largest government related agency in terms of employees.
The Postal Service currently employs nea...serp_jobs.internal_linking.show_more 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, inc...serp_jobs.internal_linking.show_more 
Facility prefers 6 months to 1 year contracts.Need is for continuous coverage.All shifts listed are required, please only submit candidates who are willing to work the below : .It will vary week to w...serp_jobs.internal_linking.show_more
Job Title : Certified Registered Nurse Anesthetist (CRNA).Service Setting : Acute Care Hospital.Coverage Type : Clinical + Call.
Coverage Period : 04 / 14 / 2025 - Ongoing.Clinical Shift Schedule : 40 hours ...serp_jobs.internal_linking.show_more
At Jacobs, we're challenging today to reinvent tomorrow by solving the world's most critical problems for thriving cities, resilient environments, mission-critical outcomes, operational advancement...serp_jobs.internal_linking.show_more
CRNA - Anesthesiology job available in Boise, Idaho
VieMed Healthcare Staffing • Boise, ID, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Care Review Clinician (RN)
Molina Healthcare • Nampa, ID, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Postal Mail Processor
Postal Jobs Source • Ontario, OR, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Postal Mail Processor
Postal Source • Boise, ID, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Postal Mail Processor - Hiring Nationwide
Postal Jobs Source • Boise, ID, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Postal Mail Processor - Paid on the Job Training
Postal Jobs Source • Ontario, OR, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Care Review Clinician, Inpatient Review (RN)
Molina Healthcare • Nampa, ID, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Postal Mail Processor - Hiring Nationwide
The Postal Service • Boise, ID, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Postal Mail Processor - Paid on the Job Training
The Postal Service • Boise, ID, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Care Review Clinician, PA (RN)
Molina Healthcare • Nampa, ID, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN Health Care Facility Surveyor - Remote
Greenlife Healthcare Staffing • Letha, ID, US
serp_jobs.filters.remote
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Postal Mail Processor - Paid on the Job Training
Postal Source • Boise, ID, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Care Review Clinician (RN) (Must reside in MI)
Molina Healthcare • Caldwell, ID, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Postal Mail Processor - Hiring Nationwide
Postal Source • Ontario, OR, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
CRNA - Anesthesiology job available in Boise, Idaho
JETT Medical Staffing • Boise, ID, US
serp_jobs.job_card.permanent
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Postal Mail Processor
The Postal Service • Boise, ID, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
RN Carceral Care Manager Remote
Molina Healthcare • Meridian, ID, US
serp_jobs.filters.remote
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
CRNA - Anesthesiology job available in Boise, Idaho
ProLocums • Boise, ID, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
CRNA - Anesthesiology job available in Boise, Idaho
Adelphi Medical Staffing, LLC • Boise, ID, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Specifications Processor
Jacobs Solutions • Boise, ID, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted