Member Services Representative
Molina Healthcare - West Allis, WI

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Respond to telephone inquiries from both Molina Members and Providers and provide accurate, efficient, and courteous service.

DUTIES AND RESPONSIBILITIES

•Respond to incoming calls from members and providers excluding provider claims calls.

•Achieve individual performance goals as it relates to call center objectives

•Engage and collaborate with other departments as applicable

•Comply with workplace safety standards

•Comply with regulatory requirements

•Demonstrate positive working relationships with peers and effectively manage conflict

•Attend meetings and training sessions as scheduled

•Show flexibility in meeting changing performance objectives consistent with Molina and department objectives

STATE PLAN / DEPARTMENT SPECIFIC DUTIES AND RESPONSIBILITIES
•Accurately record all calls in QNXT as applicable

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

•Advise callers of outstanding HEDIS services needed

•Assists callers with Web Portal registration and utilization

•Ad hoc requests for member materials

KNOWLEDGE, SKILLS AND ABILITIES
•Excellent oral and written communication skills
•Ability to use PC, typing 40 WPM
•Ability to research problems
•Ability to talk and type simultaneously
•Strong listening skills
•Empathy/passion for working with senior, disabled, low income populations and providers
•Great Interpersonal Communication Skills; Strong Verbal and Written communication skills, organizational skills and Problem Solving
•Ability to abide by Molina’s policies
•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 coworkers, clients, members, providers and customers

REQUIRED SKILLS & QUALIFICATIONS:

Required Education:
High School Diploma or GED

Required Experience:
Minimum 1 year Customer Service/Call Center experience in Healthcare or equivalent related experience
Working knowledge of Microsoft Office or other comparable software

Preferred Experience:
Experience in social services, chemical dependency services, and/or mental healthcare

Molina Healthcare - 22 months ago - save job - copy to clipboard
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Navigating the murky waters of federal health care plans is no easy feat, but Molina Healthcare's mission is to help Medicaid and...