Representative, Support Center (Bilingual English/Spanish): Overview

Molina Healthcare; Georgetown (KY); Presencial; USD 16.000 - 33.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive benefits package

Descripción de la vacante

Molina Healthcare in Kentucky is seeking a friendly, detail-oriented Customer Service Advocate to support members and providers across Medicaid, Medicare and Marketplace lines. You will handle calls, chats and emails, document inquiries, resolve issues, and maintain HIPAA standards while delivering empathetic service and timely follow-up.

This entry-level role offers exposure to multiple health plans, requires strong communication, and includes benefits and competitive pay range.

Formación

• 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.
• Strong customer service skills.
• Data processing experience.

Responsabilidades

• Provides service support to members and/or providers via phone, chat and email across multiple states and products.
• Conducts health assessments and member/provider satisfaction surveys.
• Documents pertinent details related to inquiries accurately.
• Works scheduled shifts within Molina hours of operation and adheres to breaks and overtime as needed.
• Builds rapport and responds empathetically to customers, meeting expectations.
• Captures information, identifies inquiries and concerns, and follows up timely.
• Meets performance goals for call quality, attendance, and adherence.
• Collaborates with internal/external stakeholders to resolve issues.
• Assists with member eligibility and covered benefits, provider portal, and claim status.

Conocimientos

Customer service

Attention to detail

Communication skills

HIPAA compliance

Herramientas

Microsoft Office

Descripción del empleo

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.

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

Pay Range: $11.7 - $24.02 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.