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Job Requirements of Care Review Processor I:
-
Employment Type:
Contractor
-
Location:
Phoenix, AZ (Onsite)
Do you meet the requirements for this job?
Care Review Processor I
Careers Integrated Resources Inc
Phoenix, AZ (Onsite)
Contractor
Job Title: Care Review Processor I
Location: Fully Remote
Duration: 3 Months+ (Possible Extension)
Job Description:
Job Responsibility:
Preferred Experience:
Required Education:
Preferred Education:
Location: Fully Remote
Duration: 3 Months+ (Possible Extension)
Job Description:
- Services 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.
- 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 Responsibility:
- 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 Client 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.
Preferred Experience:
- 3+ years’ experience in an administrative support role in healthcare, Medical Assistant preferred
Required Education:
- HS Diploma or GED
Preferred Education:
- Associate degree
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