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Associate Representative, Provider Services

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Company: Molina Healthcare
Location: Charleston, WV
Career Level: Associate
Industries: Healthcare, Pharmaceutical, Biotech


Job Description

Job Summary
Responsible for answering all calls from providers regarding claims issues, eligibility and benefits, and website assistance in a call center setting, and to satisfactorily resolve calls within expected response time standards. May also answer and resolve calls from members.

• Handles heavy inbound call volume.
• Responds to incoming calls mainly from providers, and on occasion from members, as required to meet departmental goals.
• Explains benefits, eligibility, provider status, state Medicaid guidelines, claim denials and any other necessary information to providers, in a clear and precise manner.
• Records calls accurately in call tracking system.
• Maintains specific quality and quantity standards.
• Maintains accurate documentation and paper files of work.


Job Qualifications

Required Education
High School Diploma or equivalent GED
Required Experience
1-2 years Customer Service/Call Center experience
Familiar with data input
Good computer skills; basic knowledge of Microsoft Office
Preferred Experience
Medicaid experience
Medical claims experience

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.


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