Representative, Support Center

Molina Healthcare; California (MO); On-site; USD 36,000 - 44,000; Full time

Job summary

Molina Healthcare is seeking a customer service representative to deliver level I support to members and providers across multiple channels. You will document inquiries, resolve issues, and maintain confidentiality while upholding Molina values in a fast-paced environment.

The role emphasizes empathy, accuracy, and timely follow-up, with opportunities to collaborate across teams and contribute to improved member experiences.

Qualifications

• Up to 1 year of customer service or call center experience.
• Strong customer service skills.
• Data processing experience.
• Attention to detail and good time-management.
• Ability to maintain HIPAA confidentiality.
• Effective verbal and written communication.
• Basic proficiency with Microsoft Office.

Responsibilities

• Provide level I support to Molina members and providers via phone, chat, and email.
• Document inquiries accurately and follow up on issues.
• Meet performance goals for call quality, attendance, and productivity.
• Collaborate with internal/external stakeholders.
• Support provider needs on eligibility, benefits, portal, and claims status.
• Uphold Molina values and provide empathetic customer service.

Skills

Customer service

Data processing

Attention to detail

HIPAA compliance

Verbal communication

Written communication

Time management

Tools

Microsoft Office

CRM software

Job description

JOB DESCRIPTION Job Summary

Provides level I support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, and identifies opportunities to improve the member and provider experience.

Essential Job Duties

• 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.

Required 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 the Health Insurance Portability and Accountability Act (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.

Preferred Qualifications

• Systems training/experience for the following : Microsoft Office, Microsoft Teams, Genesys, Salesforce, Pega, QNXT, CRM, Verint, video conferencing, CVS Caremark, Availity.
• Call center experience.
• Managed care/health care experience.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V