Member & Provider Support Specialist II

Molina Healthcare; Rio Rancho (NM); On-site; USD 30,000 - 41,000; Full time

Job summary

Molina Healthcare is seeking a Level II support center specialist to assist members and providers across Medicaid, Medicare and Marketplace lines. You will handle inquiries via phone, chat and email, resolve issues, and document interactions to ensure accuracy and timely follow-up.

You will build rapport with customers, deliver empathetic service, and strive for first-call resolution while meeting quality metrics and confidentiality requirements.

Qualifications

• 1+ year of customer service in a fast-paced environment or equivalent experience
• Customer service skills
• Data processing experience
• Attention to detail and time-management skills
• HIPAA confidentiality
• Positive working relationships with coworkers, members and providers
• Effective verbal and written communication
• Proficiency in Microsoft Office and related software

Responsibilities

• Provide level II support across channels (phone, chat, email) for Molina members/providers across Medicaid, Medicare, and Marketplace
• Assist with member/provider issues including appeals, grievances, and material maintenance
• Support process improvement and retention efforts
• Deliver excellent customer service and aim for first call resolution
• Document calls across multiple platforms accurately
• Collaborate with internal/external stakeholders to resolve inquiries
• Escalate issues based on risk and urgency
• Demonstrate provider service knowledge related to claims, authorizations, contracts and credentialing

Skills

Customer service

Data processing

Attention to detail

Verbal and written communication

Tools

Microsoft Office

Microsoft Teams

Genesys

Salesforce

Pega

QNXT

CRM

Verint

Video conferencing

Availity

Job description

Molina Healthcare is seeking a Level II support center specialist to assist members and providers across Medicaid, Medicare and Marketplace lines. You will handle inquiries via phone, chat and email, resolve issues, and document interactions to ensure accuracy and timely follow-up.

You will build rapport with customers, deliver empathetic service, and strive for first-call resolution while meeting quality metrics and confidentiality requirements.