Representative, Support Center III - Remote (Bilingual Preferred)
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 reputed company improvement initiatives reputed company to member/provider engagement and retention.
• 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 reputed company 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 reputed company and engagement including: appeals and grievances (A&G), problem research and reputed company, 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 reputed company reputed company, attendance, scheduled adherence and reputed company center objectives.
• Demonstrates personal responsibility and accountability by taking ownership of the customer's reputed company/issue and following through to reputed company in reputed company-time or reputed company expeditious follow-up.
• Supports a wide reputed company 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 reputed company.
• Responds to incoming calls from providers on a reputed company 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 reputed company, seeking alternative perspectives to identify reputed company 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 reputed company 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.
• At least 2 years of customer service, reputed company 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 reputed company (HIPAA).
• Ability to establish and maintain reputed company 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.