Lead, Support Center - Remote (Must reside in FL)

Molina Healthcare; Florida; Remote; USD 23,000 - 44,000; Full time

Job summary

Molina Healthcare is seeking a proactive customer service professional to provide lead-level support for members and providers. The role handles escalations, collaborates with multiple departments, and delivers excellent service across Medicaid, Medicare, and Marketplace lines.

Requires 4+ years in fast-paced environments, strong communication, data processing skills, and HIPAA compliance. Flexibility to work weekends is noted as a business need and a strength for success in this role.

Qualifications

• Minimum 4 years of customer service, call center or sales experience in a fast-paced environment.
• Understanding of Medicaid, Medicare and Marketplace enrollment processes.
• Strong research skills and ability to maintain coherent conversations with customers.
• Data processing experience and attention to detail.
• HIPAA confidentiality and compliance.
• Ability to communicate effectively verbally and in writing.
• Proficiency in Microsoft Office and related software.

Responsibilities

• Manage and resolve complex member/provider issues and escalations with accountability and timely follow-through.
• Collaborate with peers and other departments to resolve issues efficiently.
• Provide technical expertise and support via phone, chat, and email across multiple states/products.
• Deliver exemplary customer service to members, providers, coworkers, vendors, and agencies.
• Document all support interactions accurately across channels.
• Meet individual performance goals related to support center objectives.
• Provide training and mentorship to new and existing representatives.

Skills

Customer service

Call center experience

Sales experience

HIPAA compliance

Tools

Microsoft Office

Genesys

Salesforce

Pega

QNXT

CRM

Verint

Job description

Mon - Fri 11:30am - 8pm EST Hours (Must be flexable to work on weekends due to buisness needs)

JOB DESCRIPTION Job Summary

Provides lead level support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, identifies opportunities to improve the member and provider experience, and supports continuous quality improvement initiatives related to member/provider engagement and retention.

Essential Job Duties

• Manages and resolves complex member/provider support center issues; effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow-through to closure.
• Collaborates with peers, leadership, and other departments to resolve member/provider issues in an effective and timely manner.
• Provides technical expertise to co-workers and handles elevated escalations; provides service support to members and/or providers using one or more support center communication channels serving multiple states and/or products including but not limited to: phone, chat and email, in addition to other administrative off phone duties supporting Medicaid, Medicare and/or Marketplace lines of business.
• Provides exemplary customer service to customers including members, providers, co-workers, vendors, providers, government agencies, business partners, and the general public.
• Assists representatives with questions and escalated support center communication channels across multiple states and/or products; recognizes trends and patterns in call types and engages leadership with suggested solutions.
• Accurately documents all support center communication channels.
• Achieves individual performance goals as it relates to support center objectives.
• Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations.
• Provides training, mentoring, and support to new and existing support center representatives.

Required Qualifications

• At least 4 years of customer service, call center and/or sales experience in a fast-paced/high-volume environment, or equivalent combination of relevant education and experience.
• Understanding of insurance products including Medicaid, Medicare and Marketplace/enrollment processes.
• Customer service skills, including ability to conduct thorough research while maintaining coherent conversation with customers.
• Data processing experience.
• Attention to detail, organizational and time-management skills, and ability to manage simultaneous tasks to meet business needs.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Effective verbal and written communication skills.
• Proficiency in Microsoft Office suite and applicable software programs.

Preferred Qualifications

• Systems training/experience for the following : Microsoft Office, Microsoft Teams, Genesys, Salesforce, Pega, QNXT, CRM, Verint, video conferencing, CVS Caremark, Availity.
• Call center experience.
• Managed care/health care experience.
• Broker/health insurance license.

Molina Healthcare offers a competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $16.4 - $31.97 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.