Member & Provider Support Specialist II

Molina Healthcare; Des Moines (IA); On-site; USD 21,000 - 36,000; Full time

Job summary

Molina Healthcare in Des Moines, IA is seeking a customer service professional to provide level II support for members and providers. You will handle inquiries via phone, chat, and email across Medicaid, Medicare and Marketplace lines, delivering accurate information and timely resolution.

The role emphasizes first-call resolution, data accuracy, HIPAA compliance, and collaboration with internal teams. Strong Microsoft Office and CRM proficiency are preferred; multi-state experience is a plus.

Qualifications

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

Responsibilities

• Provides service support to members and providers via phone, chat and email across multiple states and products including Medicaid, Medicare and Marketplace.
• Supports member/provider issues in areas involving appeals, grievances, problem research and resolution, and development/maintenance of materials.
• Assists members and providers with a focus on process improvement and retention.
• Delivers first-call resolution and documents calls across platforms.
• Works scheduled shifts within Molina hours and follows break protocol; accommodates overtime/weekends as needed.
• Engages with stakeholders and takes ownership of real-time solutions and follow-up.
• Demonstrates proficiency in at least two lines of business (e.g., Medicaid, Marketplace).
• Manages multiple channels of communication (Teams, email) promptly.
• Explains provider service inquiries related to claims, authorizations, appeals, contracting and credentialing.

Skills

Customer service

Data processing

Attention to detail

Time management

HIPAA compliance

Verbal and written communication

Microsoft Office

Tools

Microsoft Office Suite

Genesys

Salesforce

Pega

CRM

Verint

Video conferencing

Job description

Molina Healthcare in Des Moines, IA is seeking a customer service professional to provide level II support for members and providers. You will handle inquiries via phone, chat, and email across Medicaid, Medicare and Marketplace lines, delivering accurate information and timely resolution.

The role emphasizes first-call resolution, data accuracy, HIPAA compliance, and collaboration with internal teams. Strong Microsoft Office and CRM proficiency are preferred; multi-state experience is a plus.