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Molina Healthcare
El Cajon, CA | Full Time
$54k-68k (estimate)
2 Months Ago
Molina Healthcare Group
El Cajon, CA | Full Time
$54k-68k (estimate)
2 Months Ago
Molina Healthcare Group
El Cajon, CA | Full Time
$54k-68k (estimate)
2 Months Ago
Rep, Customer Experience II
Molina Healthcare El Cajon, CA
$54k-68k (estimate)
Full Time | Insurance 2 Months Ago
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Molina Healthcare is Hiring a Rep, Customer Experience II Near El Cajon, CA

Job DescriptionJob SummaryProvides 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. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials
Job Duties
  • Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business.
  • Assist Members and Providers with a focus on process improvement and retention.
  • Consistent delivery of excellent customer service and First Call Resolution.
  • Accurate documentation for all calls across multiple platforms.
  • Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed
  • Demonstrate ability to quickly build rapport and respond to customers in an empathetic manner by identifying and exceeding customer expectations.
  • Aptitude to listen attentively, capture relevant information, and identify Member or Provider’s inquiries and concerns.
  • Capable of meeting/ exceeding individual performance goals established for the position in the areas of: Call Quality, Attendance, Adherence and other Contact Center objectives.
  • Able to proactively engage and collaborate with varies Internal/ External departments.
  • Personal responsibility and accountability by taking ownership of providing resolutions in real time or through timely follow up with the Member and/or Provider.
  • Supports member and provider for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other issues. Conducts initial research and works to immediate resolve issues.
  • Evaluate risk criteria and determine urgency and appropriate escalation path.
  • Proficient in at least two lines of business (e.g., Medicaid, Marketplace).
  • Manages multiple channels of communication (e.g., Teams, Jabber) within a timely manner.
  • Familiarity with Provider Service inquiries related to: Claims, Authorizations, Appeals, Contracting and Credentialing.
  • Acquainted with multiple products such as Medicaid and Marketplace and their enrollment process.
  • Ability to conduct thorough research while maintaining coherent conversation with customers.
  • Adequate communication skills in a professionally setting.
  • Competent in Microsoft Office applications (e.g., Excel, Word, PowerPoint).
Job QualificationsREQUIRED EDUCATION:
Associate’s Degree or equivalent combination of education and experience
Required Experience/Knowledge, Skills & Abilities1-3 years Sales and/or Customer Service experience in a fast paced, high volume environment
Preferred EducationBachelor’s Degree or equivalent combination of education and experience
Preferred Experience3-5 years
Preferred Systems Training
  • Microsoft Office
  • Genesys
  • Salesforce
  • Pega
  • QNXT
  • CRM
  • Verint
  • Kronos
  • Microsoft Teams
  • Video Conferencing
  • CVS Caremark
  • Availity
  • Molina Provider Portal
Preferred License, Certification, AssociationHealth and Life License
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.
Pay Range: $16 - $26.42 / HOURLY
  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Insurance

SALARY

$54k-68k (estimate)

POST DATE

07/12/2024

EXPIRATION DATE

07/14/2024

WEBSITE

molinahealthcare.com

HEADQUARTERS

ALBUQUERQUE, NM

SIZE

7,500 - 15,000

FOUNDED

1980

TYPE

Public

CEO

MARIO MOLINA

REVENUE

$10B - $50B

INDUSTRY

Insurance

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About Molina Healthcare

Molina is a managed care organization providing health care to individuals and families in 13 states & Puerto Rico via Medicaid & Medicare programs.

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