Member & Provider Support Specialist

Molina Talent Acquisition; Louisville (KY); On-site; USD 32,000 - 42,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare is seeking a level I service center professional to deliver responsive support to Molina members and providers across multiple channels, including phone, chat, and email. You will handle inquiries on eligibility, benefits, provider portals, and claims status, while maintaining confidentiality and adhering to HIPAA.

You will conduct health assessments surveys, document inquiries accurately, and work scheduled shifts with potential overtime or weekends.

Qualifications

• Up to 1 year of customer service, call center and/or sales experience in a fast-paced/high-volume environment, or equivalent education/experience.
• Customer service skills.
• 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 work relationships with coworkers, members, providers and customers.
• Effective verbal and written communication skills.
• Basic proficiency in Microsoft Office suite and applicable software programs.

Responsibilities

• Provides service support to members and/or providers using one or more channels (phone, chat, email) across multiple states.
• Conducts surveys related to health assessments and satisfaction.
• Documents pertinent details of member or provider inquiries.
• Works shifts within Molina hours; follows breaks and may overtime/weekends as needed.
• Builds rapport and responds empathetically to customers.
• Listens, captures information, identifies inquiries and concerns.
• Meets/exceeds performance goals (call quality, attendance, adherence).
• Collaborates with internal/external stakeholders.
• Takes ownership of real-time solutions and follow-up.
• Supports provider needs related to eligibility, benefits, portal, and claims status.

Skills

Customer service

Data processing

Attention to detail

HIPAA compliance

Verbal & written communication

Microsoft Office

Tools

Microsoft Office

Genesys

Salesforce

Pega

QNXT

CRM

Verint

Availity

CVS Caremark

Video conferencing

Job description

Molina Healthcare is seeking a level I service center professional to deliver responsive support to Molina members and providers across multiple channels, including phone, chat, and email. You will handle inquiries on eligibility, benefits, provider portals, and claims status, while maintaining confidentiality and adhering to HIPAA.

You will conduct health assessments surveys, document inquiries accurately, and work scheduled shifts with potential overtime or weekends.