What are the responsibilities and job description for the Care Review Processor II (Remote – Temp to Perm) position at Morgan Stephens?
Care Review Processor II (Remote – Temp to Perm)
Pay Rate: $22.00/hour
Start Date: April 28, 2025
Schedule: Monday – Friday, 8:30 AM – 5:30 PM PST
Location: Remote (must reside in one of the following states: AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater NYC), OH, TX, UT, WA (outside greater Seattle), WI)
A leading Managed Care Organization is seeking a Care Review Processor II to support their Care Access and Monitoring (CAM) team. This role plays a vital part in ensuring the timely and accurate processing of authorization requests and supporting utilization management functions. This is a remote, temp-to-perm opportunity with potential for long-term employment based on performance.
Key Responsibilities:
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Review and process authorization requests received by phone, mail, and fax.
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Verify member eligibility, benefits, and provider contracting status.
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Assign appropriate billing codes (ICD-9/ICD-10 and CPT/HCPC).
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Confirm coordination of benefits (COB) and inpatient census data.
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Communicate with providers to gather missing or additional information.
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Maintain accurate documentation in the system and meet productivity standards.
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Notify case managers and nurses of hospital admissions and member status changes.
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Collaborate with interdepartmental teams to ensure continuity of care.
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Deliver excellent customer service to both internal and external stakeholders.
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Maintain confidentiality and adhere to HIPAA and company compliance standards.
Requirements:
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High School Diploma or GED required.
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2-4 years of experience in a Utilization Review Department within a Managed Care setting.
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Prior experience in a hospital, healthcare billing, or clerical environment.
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Familiarity with medical terminology, UM (Utilization Management), and prior authorization processes.
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Strong data entry skills (minimum 40 WPM) and proficiency in Microsoft Office.
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Must be detail-oriented, analytical, and comfortable working in a fast-paced, remote setting.
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Ability to work PST hours regardless of home time zone.
Salary : $22
