Member & Provider Support Specialist

Molina Healthcare; Northern (KY); Hybrid; USD 15,000 - 33,000; Full time

Job summary

Molina Healthcare is seeking an entry-level customer service associate to support members and providers across multiple lines of business, including Medicaid, Medicare, and Marketplace. You will communicate via phone, chat, and email, document inquiries, and work within Molina’s standard hours with occasional overtime.

Your role emphasizes empathy, accurate data capture, and adherence to performance goals while building strong relationships with coworkers and customers.

Qualifications

• Up to 1 year of customer service, call center and/or sales experience in a fast-paced/high-volume environment, or equivalent combination of relevant education and 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 and effective 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 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.
• Conducts various surveys related to health assessments and member/provider satisfaction.
• Accurately documents pertinent details related to member or provider inquiries.
• Works regularly scheduled shifts within Molina hours of operation, follows protocol related to scheduled lunches and breaks, and accommodates overtime and/or weekends as needed.
• Demonstrates ability to quickly build rapport and respond to customers in an empathetic manner by identifying and exceeding customer expectations.
• Listens attentively, captures relevant information, and identifies member or provider inquiries and concerns.
• Meets or exceeds individual performance goals established for the position in the areas of: call quality, attendance, adherence and other support center objectives.
• Proactively engages and collaborates with various internal/external stakeholders.
• Demonstrates personal responsibility and accountability by taking ownership of real-time solutioning and timely member and/or provider follow-up.
• Supports provider needs related to inquiries and assistance involving member eligibility and covered benefits, provider portal, and status of submitted claims.

Skills

Customer service

Data processing

Attention to detail

HIPAA compliance

Verbal and written communication

Microsoft Office

Tools

Genesys

Salesforce

Pega

QNXT

CRM

Verint

Video conferencing

Availity

CVS Caremark

Job description

Molina Healthcare is seeking an entry-level customer service associate to support members and providers across multiple lines of business, including Medicaid, Medicare, and Marketplace. You will communicate via phone, chat, and email, document inquiries, and work within Molina’s standard hours with occasional overtime.

Your role emphasizes empathy, accurate data capture, and adherence to performance goals while building strong relationships with coworkers and customers.