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

Molina Healthcare, Inc.; Florida; Remote; USD 26,000 - 39,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a lead level Customer Service professional to provide expert support to members and providers. You will resolve complex issues, document interactions, and collaborate across departments to improve the member experience across Medicaid, Medicare and Marketplace services.

The role emphasizes strong communication, HIPAA compliance, data handling, and training of new staff. Willingness to work a schedule that includes weekends as needed and to operate across

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 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.

Responsibilities

• Manages and resolves complex member/provider support center issues; escalations are handled with accountability and follow-through.
• Collaborates with peers, leadership, and other departments to resolve issues promptly.
• Provides technical expertise to co-workers and handles elevated escalations across channels for Medicaid, Medicare and Marketplace lines.
• Delivers exemplary customer service to members, providers, coworkers, vendors, government agencies, partners and the public.
• Assists representatives with questions across multiple states/products; identifies trends and suggests solutions to leadership.
• Accurately documents all support center communications.
• Meets individual performance goals related to support center objectives.
• Demonstrates responsibility by adhering to attendance and schedule requirements.
• Provides training, mentoring, and support to new and existing support center staff.

Skills

Customer service

Research skills

Communication skills

Attention to detail

Time management

HIPAA compliance

Relationship building

Microsoft Office

Data processing

Tools

Microsoft Office

Genesys

Salesforce

Pega

QNXT

CRM

Verint

Availity

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