Care Review Processor

About This Care Review Processor Role

Molina Healthcare is hiring for a Care Review Processor position connected to Remote. This Bellencia Career Hub summary translates the original job posting into a structured, easier-to-scan career lead for job seekers comparing remote, hybrid, back-office, healthcare, billing, and administrative opportunities.

Molina Healthcare is hiring a Remote Care Review Processor to provide non-clinical administrative support to the utilization management team. This role includes data entry, authorization request processing, benefits and eligibility verification, provider inquiry documentation, clinical correspondence support, and communication with physician offices to obtain missing information.

Key Responsibilities

Daily Work You May Handle

• Provide telephone, clerical, and data entry support for the care review team.
• Enter authorization requests and provider inquiries into company systems.
• Verify eligibility, benefits, coordination of benefits, and provider contracting status.
• Document diagnosis and treatment requests.
• Track hospital census details, admissions, discharges, and billing codes.
• Respond to authorization requests submitted by phone, fax, and mail.
• Contact physician offices to request missing information.
• Support clinical correspondence and letter generation.
• Maintain accuracy, confidentiality, and compliance with regulatory requirements.
• Collaborate with internal departments and team members.

The core workflow centers on accuracy, research, and keeping accounts or records moving through the correct process. A strong applicant should be comfortable reviewing details, comparing information across systems, updating records, and documenting outcomes in a way that supports clean handoffs between departments.

Minimum Requirements

Education, Experience, and Technical Knowledge

• At least 1 year of administrative support experience.
• Healthcare administrative support experience preferred.
• Experience supporting correspondence or clinical communications.
• Strong attention to detail.
• Ability to work within regulatory and internal requirements.
• Strong organizational and time-management skills.
• Ability to manage multiple queues and deadlines.
• Excellent verbal and written communication skills.

For this type of role, employers often look for a mix of practical experience, system confidence, and the ability to understand payer, billing, account, or documentation rules. Even when the role is not heavily phone-based, communication still matters because the work may involve coordination with internal teams, management, or partner departments.

Preferred Qualifications

Helpful Background for Stronger Applicants

• Previous Molina Correspondence Processor experience.
• Healthcare correspondence experience.
• Clinical communications experience.
• Understanding of regulatory and accreditation rules related to clinical determinations.
• Utilization management support experience.
• Authorization processing experience.

Phone Level and Work Style

Bellencia phone-level estimate: Phone-Moderate. This classification is based on the wording in the pasted posting. Because this is an estimate, applicants who need non-phone or low-phone work should confirm phone expectations during the interview. The posting reads most strongly as Utilization Management Support work with a focus on written records, account review, payer details, research, and follow-up.

Pay, Schedule, and Location Details

Pay: $14.00 – $26.42 per hour. Schedule: Full-Time. Job type: Full-time. Location or work arrangement: Remote. Applicants should verify the official application page for the most current pay range, benefits, shift expectations, equipment rules, and state eligibility requirements.

Best-Fit Applicant Profile

This role may be a good match for someone who enjoys detailed, process-driven work and can stay consistent with repetitive but important tasks. It may fit job seekers with experience in medical billing, revenue cycle, accounts receivable, claims, refunds, charge capture, payer research, payment posting, documentation review, insurance eligibility, or healthcare administrative support.

• You are comfortable researching account details and correcting issues before they become larger problems.
• You can follow written procedures and keep documentation clean, accurate, and audit-ready.
• You prefer structured back-office work over sales-driven or heavy call-center duties.
• You can manage confidential information professionally and escalate unclear issues when needed.

Resume Keywords to Consider

Relevant resume keywords may include Care Review Processor, Utilization Management Support, documentation, account research, workflow queues, Excel, payer requirements, reconciliation. Use only the keywords that honestly match your experience. The strongest applications usually connect past duties directly to the employer’s listed responsibilities.

How to Apply

Use the official application link for this job posting when you are ready to apply. Before submitting, review the required experience, confirm the schedule, and tailor your resume summary and bullet points toward the highest-priority duties in this listing.