Job description

JOB DESCRIPTION

Job Summary

Provides customer support and stellar service to meet the needs of our Molina members and providers.
Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions.
Provides product and service information, and identifies opportunities to improve our member and provider experiences.

KNOWLEDGE/SKILLS/ABILITIES

Responsible for owning, handling and resolving complex issues.

Recognizes trends and patterns in call types and engages leadership with suggested solutions.

Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.

Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner.

Provide technical expertise to co-workers and handles elevated calls.

Provide exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public.

Effective communication skills in a professionally setting, both spoken and verbal.

Manages multiple channels of communication (e.g., Teams, Jabber) within a timely manner.

Familiarity with processes related to Claim Adjustments and Adjudication.

Familiarity with Provider Service inquiries related to: Claims, Authorizations, Appeals, Contracting and Credentialing.

Accurate documentation for all calls across multiple platforms.

Proficient in Microsoft Office applications (e.g., Excel, Word, PowerPoint).

Consistently exceeding individual performance goals established for the position in the areas of: Call Quality, Attendance, Adherence and other Contact Center objectives.

Assists with training needs of employees or training classes as needed along with providing coaching/feedback and mentoring agents.

Evaluate risk criteria and determine urgency and appropriate escalation path.

Proficient in two lines of business or more (e.g., Medicaid, Marketplace, Medicare).

Lead by the Molina Values

Integrity Always : Set a good example by continuously Doing the Right Thing.

Absolute Accountability : Take responsibility for ensuring escalated calls are handled with excellent service.

Supportive Teamwork : Eagerly assist your co-workers

Honest and Open Communication : Be true to your word

Member and Community Focused : Act as an advocate on behalf of our callers

Preferred Systems Training :
Salesforce

Pega

Genesys

QNXT

CRM

Verint

Kronos

Genesys

Microsoft Office Professional (Excel, PowerPoint, Word).

Microsoft Teams

Video Conferencing

CVS Caremark

JOB QUALIFICATIONS

REQU I RED ED U C A TI O N :
Associate’s Degree or equivalent combination of education and experience

REQU I RED E X PE R I E N C E:
5-7 years

Must be Bilingual able to read and write (Spanish)

Proficient on CA Medicaid

PR E FE R RED ED U C A TI O N :
Bachelor’s Degree or equivalent combination of education and experience

PR E FE R RED E X PE R I E N C E:
7-9 years

PHY S I C AL DEM A N D S :
W o rki n g en v i r o nm ent is g e n erally f a vo r a b le and li gh t i n g and t e m p erature are a d eq u at e . W o rk is g eneral l y p erf o r m ed in an o ff i ce or home office e n v i r o n m ent in w h i c h t h ere is o n l y m i n i m al e x p o su r e to u np leasa n t a nd /o r ha z ar d o u s w o rki n g c o nd iti o n s. M u s t h a v e t h e a b ility t o s i t f o r l o n g p eri o d s. Rea s o n a b le acc om mo d a ti o n s m a y be m a d e to e n a b le in d i v i du als with d i sa b ilities t o p er f orm the essential function.

Pay Range: $16.40 - $31.97 a hour*

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

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

#PJCC

#LI-BEMORE

apartamentosquality.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, apartamentosquality.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, apartamentosquality.com is the ideal place to find your next job.