Member & Provider Support Specialist II

Molina Healthcare; United States; À distance; USD 36 000 - 52 000; Plein temps

Résumé du poste

Molina Healthcare is seeking an entry-to-mid level Customer Service Associate to provide support to members and providers across multiple channels, including phone, chat, and email. You will address benefits, claims, eligibility, and portal issues, documenting interactions and escalating when needed.

Ideal candidates have at least 1 year in a fast-paced environment, strong communication skills, and a commitment to HIPAA compliance.

Qualifications

• At least 1 year of customer service, call center and/or sales experience in a fast-paced/high-volume environment.
• 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 requirements.
• Effective verbal and written communication skills.
• Proficiency in Microsoft Office suite and applicable software programs.

Responsabilités

• Provides service support to members and/or providers using multiple channels (phone, chat, email) across states/products.
• Supports member/provider issues including appeals and grievances and maintenance of related materials.
• Assists with process improvement and retention initiatives.
• Delivers high-quality customer service and strives for first-call resolution.
• Documents all calls across platforms accurately and timely.
• Adheres to Molina hours, lunch/break schedules, and overtime/weekend requirements.
• Engages with stakeholders to resolve inquiries and concerns efficiently.
• Manages provider service inquiries related to claims, authorizations, contracting and credentialing.

Connaissances

Customer service

Data processing

Attention to detail

Time management

Verbal and written communication

HIPAA compliance

Outils

Microsoft Office

Microsoft Teams

Genesys

Salesforce

Pega

QNXT

CRM

Verint

Description du poste

Molina Healthcare is seeking an entry-to-mid level Customer Service Associate to provide support to members and providers across multiple channels, including phone, chat, and email. You will address benefits, claims, eligibility, and portal issues, documenting interactions and escalating when needed.

Ideal candidates have at least 1 year in a fast-paced environment, strong communication skills, and a commitment to HIPAA compliance.