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Healthcare - Care Review Processor I

Role overview

Qualifications

  • HS Diploma or GED
  • Associate degree
  • 3+ years' experience in an administrative support role in healthcare
  • 1-3 years' experience in an administrative support role in healthcare

Responsibilities

  • Provides telephone, clerical, and data entry support for the Care Review team.
  • Provides computer entries of authorization request/provider inquiries.
  • Responds to requests for authorization of services submitted via phone, fax, and mail.
  • Contacts physician offices to request missing information from authorization requests.

Key facts

  • Remote from: Anywhere
  • Full time
  • Mid-level (2-5 years)
  • 0
  • English

Hard skills

Other skills

  • Clerical Works
  • Communication
  • Teamwork

About the company

Saviance Technologies Pvt. Ltd. logo

Saviance Technologies Pvt. Ltd.

Saviance Technologies is a US Healthcare IT Service provider focusing on Patient Engagement with Innovative Products and Solutions like Patient Intake Tablet, iHealthConnect Wellness Portal, Mobile Applications, Actionable Analytics and ICD-10 Testing Services. Incorporated in 1999 in New Jersey, with over 15 years of excellent industry track record, Saviance offers services & solutions that enable enterprises to achieve critical objectives. Saviance is a Gold Category Corporate Member with Healthcare Information Management Systems Society (HIMSS), member of mHealth Alliance and Corporate member of NJ-HITEC. We are awarded by INC. 5000 as one of the fastest growing privately held companies in North America. Saviance is also ranked among the Fast 50 Asian American Businesses in the United States by USPAACC (US Pan Asian American Chamber of Commerce) and selected as a 2014 "Top Business"​ recipient byDiversityBusiness.com. A certified Minority Business Enterprise recognized by NMSDC, Saviance is also partner with leading global brands such as Microsoft, Amazon Web Services, Apple, Samsung and Red Hat.

Company details

Company typeSME
Company size51 - 200

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Job description

100% remote but most work PST hours
needs dual monitors and a docking station

Job Description:

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, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
As part of this role, the selected candidate will be scheduled to work weekends in alignment with department coverage needs.

Job Qualifications
Required Education
HS Diploma or GED

Preferred Education
Associate degree

Preferred Experience
3+ years' experience in an administrative support role in healthcare, Medical Assistant preferred.


Must Have Skills:
1-3 years' experience in an administrative support role in healthcare.

Day to Day Responsibilities: • 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 Molina operational timeframes.
• Contacts physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.

Required Years of Experience: 1-3 years' experience in an administrative support role in healthcare.

Experience. Experience with Medical Terminology.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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