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Company: Molina Healthcare
Location: Irving, TX
Career Level: Mid-Senior Level
Industries: Healthcare, Pharmaceutical, Biotech

Description



Job Description

Job Summary
Provides new and existing members with the best possible service in relation to billing inquiries, service requests, suggestions and complaints. Resolves member inquiries and complaints fairly and effectively. Provides product and service information to members, and identifies opportunities to maintain and increase member relationships. Recommends and implements programs to support member needs.

Knowledge/Skills/Abilities
• Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public.
• Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care.
• Supervises hiring, ensuring effective training, ongoing monitoring and Quality Assurance, evaluations and any disciplinary actions of member services representatives.
• Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
• Ensures compliance with state and regulatory requirements.

Qualifications

Job Qualifications

Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
3-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years

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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