Member & Provider Experience Specialist II

Molina Healthcare; Northern (KY); Hybrid; USD 17,000 - 36,000; Full time

Job summary

Molina Healthcare is seeking a Level II Support Center Customer Service professional to assist Molina members and providers across multiple states and products, handling inquiries via phone, chat, and email. The role emphasizes rapid issue resolution, documentation, and adherence to HIPAA guidelines.

Responsibilities include supporting appeals and claims, driving process improvements, maintaining first-call resolution, and collaborating with internal/external stakeholders.

Qualifications

• At least 1 year of customer service in a fast-paced/high-volume environment or equivalent combination of education and experience.
• Customer service skills.
• Data processing experience.
• Attention to detail, organizational and time-management skills.
• Ability to maintain confidentiality and comply with HIPAA.
• Effective verbal and written communication skills.
• Proficiency in Microsoft Office suite and applicable software programs.

Responsibilities

• Provides service support to members and/or providers via one or more channels (phone, chat, email) across multiple states/products.
• Supports member/provider issues related to appeals, grievances, problem resolution, and materials.
• Assists with process improvement and retention efforts.
• Delivers high-quality customer service and first-call resolution.
• Documents calls accurately across platforms.
• Works scheduled shifts within Molina hours and adheres to break/lunch protocols; may include overtime/weekends.

Skills

Customer service

Data processing

HIPAA compliance

Communication skills

Call center experience

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Level II Support Center Customer Service professional to assist Molina members and providers across multiple states and products, handling inquiries via phone, chat, and email. The role emphasizes rapid issue resolution, documentation, and adherence to HIPAA guidelines.

Responsibilities include supporting appeals and claims, driving process improvements, maintaining first-call resolution, and collaborating with internal/external stakeholders.