Care Review Processor with Managed Care Exp. -- Remote | WFH - #9835161

Get.It Recruit - Administrative

Date: 3 days ago
City: Long Beach, CA
Contract type: Full time
Join our dedicated team in a pivotal role that supports our mission to deliver high-quality, cost-effective healthcare services. As a Care Review Processor, you will be integral to our Care Access and Monitoring (CAM) team, providing essential clerical support and data management for members requiring hospitalization and other healthcare services. This position is remote, offering a flexible schedule with the necessity to accommodate PST working hours.


Data Management: Accurately enter necessary information into our systems from various sources and verify member eligibility and coverage.

Communication: Handle inbound inquiries via phone, mail, or fax, ensuring timely and accurate responses. Generate correspondence with attention to detail in selecting templates and checking grammar.

Support and Coordination: Assist in managing authorization requests and provider inquiries, assigning billing codes, verifying service requests, and coordinating with healthcare providers to obtain additional information as needed.

Team Collaboration: Work closely with interdepartmental teams to support the continuity of care for members across behavioral health and long-term care services.

Quality and Compliance: Adhere to department standards for quality assurance, participate in required training, and maintain strict confidentiality in compliance with HIPAA regulations.


Primary: Tuesday to Saturday, 10:00 AM - 6:30 PM PST

Alternate: Sunday to Thursday, 10:00 AM - 6:30 PM PST

Flexibility to work additional hours and weekends as needed.


Minimum of 2 years' experience in a Utilization Review role within a Healthcare Managed Care environment.

Familiarity with hospital or healthcare settings, including clerical, audit, or billing roles.

Proficient in medical terminology and Microsoft Office suite.

Strong typing skills (minimum 40 WPM).

Effective communication skills and the ability to work independently or as part of a team.

High School Diploma or GED required; some college education preferred.

Technology Requirements

Provided equipment includes a laptop, keyboard, mouse, headset, and dual monitors for optimal performance.

Job Perks

Opportunity for contract extension or transition to permanent employment based on performance.

Fully remote role, promoting work-life balance.

Competitive hourly rate and structured training for professional development.

Application Process

Interested candidates should apply with a resume and cover letter. Selected candidates will be invited for a video interview via Teams.

Employment Type: Full-Time

How to apply

To apply for this job you need to authorize on our website. If you don't have an account yet, please register.

Similar jobs


City of Long Beach, Long Beach, CA
6 days ago
DescriptionApplications are available online beginning Friday, May 10, 2024 through 4:30 pm, Friday, May 24, 2024. EXAMPLES OF DUTIESUnder general supervision, performs technical accounting support functions in the preparation, maintenance, and processing of accounting records and financial transactions; inputs, reviews, and approves financial transactions and data in accordance with Generally Accecpted Accounting Principles (GAAP) and City policy for accuracy; identifies,...

Sr. Business Systems Analyst (BSA)

ShiftCode Analytics, Inc., Long Beach, CA
1 week ago
Local Only.We would strongly prefer candidates who are LOCAL to the Long Beach, CA area. A VIDEO interview will be required and the selected candidate will work in a hybrid manner, with at least 2 days per week in the Long Beach office .We need a Sr. Business Systems Analyst (BSA) for a 9+ month contract for a client in...

Executive Assistant

Robert Half, Long Beach, CA
$23.75 - $27.5 per hour
3 weeks ago
DescriptionWe are offering a contract to hire employment opportunity for an Executive Assistant in Long beach, California. This role involves supporting the CEO with time management, scheduling, event management, and liaising with clients. The Executive Assistant will also be responsible for data organization, drafting documents, and managing marketing materials.Responsibilities Actively manage the CEO's calendar, ensuring timeliness and efficiency Draft and...