Care Review Processor

Welcome to Molina Healthcare, a leader in providing affordable and quality healthcare services to our members. We are currently seeking a Care Review Processor to join our dynamic team. As a Care Review Processor, you will play a crucial role in ensuring our members receive the best possible care by reviewing and processing requests for medical services. We are looking for a detail-oriented and compassionate individual who is dedicated to making a positive impact in our members' lives. If you are passionate about delivering exceptional customer service and have a strong understanding of medical terminology and healthcare procedures, we invite you to apply for this rewarding position.

1. Review and process requests for medical services from members, ensuring accuracy and completeness.
2. Utilize knowledge of medical terminology and healthcare procedures to accurately review and process requests.
3. Collaborate with medical professionals and other team members to ensure timely and appropriate care for members.
4. Communicate with members and providers to obtain necessary information and clarify any discrepancies in requests.
5. Maintain accurate and detailed records of all processed requests.
6. Adhere to company policies, guidelines, and regulatory requirements when processing requests.
7. Identify and escalate any potential issues or concerns to the appropriate parties.
8. Provide exceptional customer service to members and providers, addressing any questions or concerns in a timely and professional manner.
9. Continuously stay informed and updated on changes in healthcare regulations and procedures.
10. Participate in training and development opportunities to enhance job knowledge and skills.
11. Work closely with other team members to ensure efficient and effective processing of requests.
12. Maintain confidentiality and discretion when handling sensitive member information.
13. Contribute to a positive and collaborative work environment by actively participating in team meetings and sharing ideas for improvement.
14. Conduct quality assurance checks to ensure accuracy and compliance in all processed requests.
15. Adhere to productivity and performance standards set by the company.

According to JobzMall, the average salary range for a Care Review Processor in Savannah, GA, USA is $36,000 - $50,000 per year. This may vary depending on the specific company, experience level, and qualifications of the individual.

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.