Representative, Support Center (Bilingual English/Spanish)

Molina Healthcare; New Mexico; On-site; USD 21,000 - 33,000; Full time

Job summary

Molina Healthcare is seeking an entry-level Customer Service Representative to provide support to members and providers across multiple states using phone, chat, and email channels. You will document inquiries, manage schedules, and collaborate with internal teams to resolve issues promptly while maintaining confidentiality.

The role emphasizes empathetic communication, quality assurance, and adherence to Molina guidelines.

Qualifications

• Up to 1 year of customer service in a fast-paced/high-volume environment or equivalent education/experience.
• Customer service skills.
• Data processing experience.
• Attention to detail and strong organizational/time-management abilities.
• Ability to maintain confidentiality and comply with HIPAA.

Responsibilities

• Provide level I support center customer service to Molina members and providers via phone, chat and email.
• Document pertinent details of member/provider inquiries accurately.
• Work scheduled shifts within Molina hours and follow break protocols; overtime/weekends as needed.
• Build rapport and respond empathetically to customers; meet or exceed performance goals for call quality and attendance.
• Identify inquiries, capture relevant information, and coordinate timely follow-ups with members/providers.
• Support provider needs related to eligibility, benefits, provider portal, and claim status.

Skills

Customer service

Communication

Time management

Data processing

HIPAA compliance

Tools

Microsoft Office

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

Pay Range: $15.4 - $24.02 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.