JOB DESCRIPTION
Onsite Position - 95823, Zip Code
Job Summary
Provides customer support and stellar service to meet the needs of our Molina members and providers.
Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions.
Provides product and service information, and identifies opportunities to improve our member and provider experiences.
Responsible for continuous quality improvements regarding member engagement and member retention.
Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials.
KNOWLEDGE/SKILLS/ABILITIES
Support Inbound/Outbound calls from Members or Providers on variety of complex issues.
Bilingual skills: must be fluent in English and Spanish
Assist Members and Providers with a focus on process improvement and retention.
Consistent delivery of excellent customer service and First Call Resolution.
Accurate documentation for all calls across multiple platforms.
Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed
Demonstrate ability to quickly build rapport and respond to customers in an empathetic manner by identifying and exceeding customer expectations.
Aptitude to listen attentively, capture relevant information, and identify Member or Provider’s inquiries and concerns.
Capable of meeting/ exceeding individual performance goals established for the position in the areas of: Call Quality, Attendance, Adherence and other Contact Center objectives.
Able to proactively engage and collaborate with varies Internal/ External departments.
Personal responsibility and accountability by taking ownership of providing resolutions in real time or through timely follow up with the Member and/or Provider.
Supports member and provider for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other issues.
Conducts initial research and works to immediate resolve issues.
Evaluate risk criteria and determine urgency and appropriate escalation path.
Proficient in at least two lines of business (e.
g.
, Medicaid, Marketplace).
Manages multiple channels of communication (e.
g.
, Teams, Jabber) within a timely manner.
Familiarity with Provider Service inquiries related to: Claims, Authorizations, Appeals, Contracting and Credentialing.
Acquainted with multiple products such as Medicaid and Marketplace and their enrollment process.
Ability to conduct thorough research while maintaining coherent conversation with customers.
Adequate communication skills in a professionally setting.
Competent in Microsoft Office applications (e.
g.
, Excel, Word, PowerPoint).
Preferred Systems Training:
Microsoft Office
Genesys
Salesforce
Pega
QNXT
CRM
Verint
Kronos
Microsoft Teams
Video Conferencing
CVS Caremark
Availity
Molina Provider Portal
Job Qualifications
REQUIRED EDUCATION:
Associate’s Degree or equivalent combination of education and experience
REQUIRED EXPERIENCE:
1-3 years Sales and/or Customer Service experience in a fast paced, high volume environment
PREFERRED EDUCATION:
Bachelor’s Degree or equivalent combination of education and experience
PREFERRED EXPERIENCE:
3-5 years
Healthcare experience
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
Health and Life License
PHYSICAL DEMANDS:
Working environment is generally favorable and lighting and temperature are adequate.
Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions.
Must have the ability to sit for long periods.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJCC
#LI-JR1
Pay Range: $12.
19 - $26.
42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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