Care Review Processor

Job Summary

A company is looking for a Care Review Processor.

Key Responsibilities

• Provide clerical and data entry support for members requiring hospitalization and utilization review
• Verify member eligibility, benefits, and process authorization requests through various communication methods
• Maintain confidentiality and comply with HIPAA while meeting department quality and productivity standards

Required Qualifications

• 1-2 years of experience in a Utilization Review Department in a Managed Care Environment
• Previous experience in a hospital or healthcare clerical, audit, or billing role
• Knowledge of Medi-Cal and medical terminology
• High School diploma required
• Proficient in Microsoft Office with a minimum data entry speed of 40 WPM