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Job Description

Job Summary

Handles escalated inquiries for members and/or providers reporting into the Contact Center. Provides written response to public facing requests/questions that impact Molina’s brand

Knowledge/Skills/Abilities

• Strong communication skills; strong verbal and written communication skills, organizational skills and problem solving

• Experience with public facing customer service such as social media, marketing, and/or public relations

• Experience with call center campaigns related to health care initiatives

• Experience with multiple products and markets

• Ability to maintain attendance to support required quality and quantity of work

• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

• Ability to establish and maintain positive and effective work relationships with leadership, stakeholders, clients, members, providers, and customers

• Knowledge of MS Office/Excel/Teams

• Attention to detail

• Knowledgeable with Microsoft Office and Social Media platforms

• Ability to multitask

+ Responds to internal and external customers in a timely and accurate manner, treating them with respect and courtesy

+ Responds and resolves complex member and provider issues

+ Conducts thorough research to achieve immediate and accurate responses.

+ Knowledge of multiple plan/line of business benefits and processes

+ Compliance work including various privacy forms

+ Responds to social media, text, email and web portal communications in accordance with contractual and/or compliance requirements

+ Influencing and educating members on healthcare needs

+ Conducts outbound calls as required

+ Documents every interaction accurately (call, mail, email, etc.) data entry

+ Engages and collaborates with other departments to identify responses to complex inquires

• Responsible and accountable to maintain up to date knowledge of processes and procedures

+ Pursues learning opportunities to develop and broaden skill set and expertise

+ Attends meetings and training as scheduled

+ Demonstrate personal responsibility and accountability by meeting attendance, schedule adherence, quality and production expectations

+ Flexible and able to meet changing performance objectives consistent with department objectives

+ Proactively manages member and provider expectations to consistently provide positive member experience

+ Assists with developing training materials and departmental resources

+ Assists with or conducts training

+ Ability to abide by Molina’s policies

+ Assists with special projects or other duties as assigned

Job Qualifications

REQU** **I** **RED ED** **U** **C** **A** **TI** **O** **N** **:

High School Diploma or GED

REQU** **I** **RED E** **X** **PE** **R** **I** **E** **N** **C** **E** **:

+ Minimum 4 years customer experience in healthcare or equivalent related experience

+ 2 years of experience and knowledge of different social media platforms, text, Outlook and web portal platforms.

+ Working knowledge of State Medicaid, Medicare and Marketplace programs

+ Basic understanding of claims processing guidelines

+ Experience with elevated written and communication skills

+ Ability to respond through writing on sensitive public facing topics

+ Working knowledge of Microsoft Office, Sprinklr or other comparable software systems

PR** **E** **FE** **R** **RED ED** **U** **C** **A** **TI** **O** **N** **:

Associate’s or Bachelor’s degree

PR** **E** **FE** **R** **RED E** **X** **PE** **R** **I** **E** **N** **C** **E:

+ Working knowledge of medical insurance billing practices

+ Public Relations experience

+ Ability to quickly build rapport

+ Knowledge of appointment setting/confirmation experience

+ Experience with multi party calls/liaison/advocate

+ Organizational brand or marketing experience

+ Working knowledge of medical terminology, CPT and ICD-10 coding practices

PHY** **S** **I** **C** **AL DEM** **A** **N** **D** **S** **:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

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: $17.85 - $31.97 / HOURLY

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