Care Review Processor I

Job Title: Care Review Processor
Location: Remote (California residents only preferred) | Based out of Long Beach, CA (ZIP 90802)
Pay Rate: $20–$25/hour
Duration: 3-Month Contract (Not Temp-to-Hire)

Schedule:

• Training: Monday–Friday, 8:00 AM – 5:00 PM PST
• Post-training: Preferred weekday shifts + Required Saturday & Sunday availability

Position Overview

We are seeking a Care Review Processor to provide telephone, clerical, and data entry support for the Care Review team within a healthcare environment. This role supports authorization processing, provider inquiries, and coordination activities while ensuring compliance with operational timeframes.

Key Responsibilities

• Provide telephone, clerical, and data entry support to the Care Review team
• Enter and manage authorization requests and provider inquiries in the system
• Verify eligibility and benefits, including coordination of benefits status
• Process hospital census updates related to admissions and discharges
• Respond to faxed authorization requests according to Molina operational timeframes
• Assist with outbound calls, fax distribution, and clerical processing
• Create “shells” in the system for incoming requests
• Identify IPA delegations and apply knowledge of DOFR (Division of Financial Responsibility)

Required Qualifications

• High School Diploma or equivalent
• Minimum 3 years of relevant healthcare experience (IPA or health plan experience preferred)
• Strong data entry, clerical, and organizational skills
• Experience working with authorization workflows and provider inquiries
• Knowledge of IPA delegations and DOFR is required

Additional Details

• Fully remote, but candidates must reside in California
• This is a contract-only role (minimum 3 months) with no conversion to permanent employment

If you have a strong background in healthcare operations and are comfortable working in a fast-paced, detail-oriented environment, we encourage you to apply.