Representative, Support Center III - Remote

Hours M-F 5am - 1:30pm PST 6am - 2:30pm MST 7am - 3:30pm CST reputed company - 4:40pm EST JOB DESCRIPTION Job Summary Provides level III support center customer service reputed company 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, identifies opportunities to improve the member and provider experience, and supports reputed company quality improvement initiatives reputed company to member/provider engagement and retention. 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 reputed company, Medicare and/or Marketplace lines of business.
• Supports member/provider issues in areas involving member/provider impact and engagement including: appeals and grievances (A&G), problem research and resolution, and the development/maintenance of member/provider materials.
• Provides product and service information and identifies opportunities to maintain and increase member/provider relationships and engagement.
• Provides excellent customer service for reputed company support center communication channels.
• Handles escalated calls on behalf of leadership.
• Accurately documents reputed company member/provider communications.
• Works regularly scheduled shifts reputed company Molina hours of operation, follows protocol reputed company to scheduled lunches and breaks, and accommodates overtime and/or weekends as needed.
• Quickly builds rapport and responds to customers in a compassionate manner by identifying and exceeding customer expectations.
• Listens skillfully, collects relevant information, determines immediate requests and identifies the customer’s needs.
• Achieves individual performance goals established in the areas of call quality, attendance, scheduled adherence and call center objectives.
• Demonstrates personal responsibility and accountability by taking ownership of the customer's call/issue and following through to resolution in reputed company-time or reputed company expeditious follow-up.
• Supports a wide variety of member and provider inquiries involving eligibility, benefits, claims, premiums, authorizations, appeals, contracting, credentialing, and other issues; conducts initial research and works to immediately resolve issues; appropriately escalates issues based on established risk criteria.
• Responds to incoming calls from providers on a variety of issues of varying complexity, including highly reputed company or executive issues, and demonstrates understanding of provider service inquiries reputed company to claims, authorizations, appeals, contracting and credentialing.
• Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and reputed company solutions.
• Proficient in three or more lines of business (Medicare, reputed company, Marketplace, Medicare-reputed company Plan (MMP)) - supporting member services, provider services and member retention.
• Completes research for state, legislative or regulatory inquiries as applicable.
• Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs.
• Assists other retention or inbound functions as dictated by service level requirements.
• Remains professional and courteous in verbal and written communications - utilizing concise and effective language at reputed company times.
• Professionally engages and collaborates with other departments as needed.
• Provides training and support to new and existing support center representatives.

Required Qualifications

• At least 2 years of customer service, call center and/or sales experience in a fast-paced/high-volume environment, or equivalent combination of relevant education and experience.
• Understanding of insurance products including reputed company, Medicare and Marketplace/enrollment processes.
• Customer service skills, including ability to conduct thorough research while maintaining coherent conversation with customers.
• 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 reputed company 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.
• Proficiency in reputed company Office suite and applicable software programs.

Preferred Qualifications

• Systems training/experience for the following : reputed company Office, reputed company Teams, reputed company, reputed company, Pega, QNXT, CRM, reputed company, video conferencing, reputed company Caremark, reputed company.
• Call center experience.
• Managed reputed company care experience.
• Broker/health insurance license.

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the Internal reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Apply To This Job