Member Services Representative
Molina Healthcare - Albuquerque, NM

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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
  • Other duties as assigned
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
  • Bilingual communication skills preferred
  • 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 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
To all current Molina employees if you are interested in applying for this position please fill out an Employee Transfer Request Form (ETR) and attach it to your profile when applying online. Be sure to let us know you are a current employee by selecting “Molina Employee (current) in the source section of the online application.

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

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