Care Review Processor II

A company is looking for a Care Review Processor II to support their Care Access and Monitoring team in a remote, temp-to-perm role. Key Responsibilities Review and process authorization requests received by phone, mail, and fax Verify member eligibility, benefits, and provider contracting status Communicate with providers to gather missing or additional information and maintain accurate documentation Required Qualifications High School Diploma or GED required 2-4 years of experience in a Utilization Review Department within a Managed Care setting Prior experience in a hospital, healthcare billing, or clerical environment Familiarity with medical terminology, UM, and prior authorization processes Strong data entry skills (minimum 40 WPM) and proficiency in Microsoft Office

Apr 2, 2025 - 19:49

A company is looking for a Care Review Processor II to support their Care Access and Monitoring team in a remote, temp-to-perm role. Key Responsibilities Review and process authorization requests received by phone, mail, and fax Verify member eligibility, benefits, and provider contracting status Communicate with providers to gather missing or additional information and maintain accurate documentation Required Qualifications High School Diploma or GED required 2-4 years of experience in a Utilization Review Department within a Managed Care setting Prior experience in a hospital, healthcare billing, or clerical environment Familiarity with medical terminology, UM, and prior authorization processes Strong data entry skills (minimum 40 WPM) and proficiency in Microsoft Office