Representative, Support Center (10:30am - 7PM CST Monday-Friday)

Molina Healthcare; United States; On-site; USD 32,000 - 42,000; Full time

Job summary

Molina Healthcare seeks a Customer Service Representative to provide level I support to Molina members and providers. The role includes answering questions, resolving issues across Medicaid, Medicare, and Marketplace lines, and delivering service with Molina values.

You will handle phone, chat, and email communications across multiple states, document inquiries, and strive to meet performance goals. A positive, empathetic approach and strong communication skills are essential.

Qualifications

• Up to 1 year of customer service experience in a high-volume environment.
• Strong customer service and listening skills.
• Proficient in data entry and basic data processing.
• Ability to protect confidentiality and comply with HIPAA.
• Effective written and verbal communication; basic MS Office skills.

Responsibilities

• Provide level I support to members and/or providers using multiple channels (phone, chat, email) across Medicaid, Medicare and Marketplace lines.
• Document pertinent details related to inquiries accurately in the system.
• Meet or exceed individual performance goals (call quality, attendance, adherence).
• Follow schedules, breaks, and accommodate overtime/weekends as needed.
• Build rapport with customers and respond empathetically to inquiries and concerns.
• Capture relevant information and identify member/provider inquiries and concerns.
• Collaborate with internal/external stakeholders to resolve issues.
• Take ownership of real-time solutions and timely follow-up with members/providers.
• Assist providers with inquiries related to eligibility, benefits, portal access, and claims status.

Skills

Customer service

Data processing

Attention to detail

HIPAA compliance

Verbal & written communication

Microsoft Office

Tools

Genesys

Salesforce

Pega

QNXT

CRM software

Verint

Microsoft Teams

Job description

JOB DESCRIPTION

Work hours are 10:30am-7pm CST Monday through Friday

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