Care Review Processor

Job Description

AltaStaff is a staffing agency currently looking for a Care Review Processor for one of our Managed Care partners.

This is a full-time position that is fully remote! Candidates must reside in FL, NY (outside greater NYC), GA, MI, OH, WI, IA, NM or KY

Pay: $20.00 - $22.00 hourly

Schedule: Monday - Friday, 8:30-5:30 PST

Position Purpose: Provides support to the Case Management staff performing non clinical activities and supporting the management of the department

Job Responsibilities:

Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate Health Care Services staff

Provide computer entries of authorization request/provider inquiries by phone, mail, or fax.

Verify member eligibility and benefits

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.

Contact’s physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.

Job Qualifications:

HS Diploma or GED, Associates preferred.

1-2+ years of previous health admin experience

1-2+ years of experience in a Utilization Review Department and/or ICD and CPT coding

Previous Hospital or Healthcare clerical, audit or billing experience

Experience with Medical Terminology.

If you've applied and would like to view your application status, please visit:

AltaStaff is an Equal Employment Opportunity Employer. We provide equal employment opportunities to all qualified applicants for employment without regard to age, race, color, creed, religion, sex, marital status, national origin, ancestry, citizenship, disability, veteran status, sexual orientation, or any other protected status, in accordance with applicable federal, state, and local laws.

INDLP

#ZR

Full-time

Fully remote