Specialist, Customer Experience - Bilingual Remote
Job Description
Job Summary
Handles escalated inquiries for members and/or providers reporting into the Contact Center. Provides written response to public facing requests/questions that impact Molina’s brand
Knowledge/Skills/Abilities
• Strong communication skills; strong verbal and written communication skills, organizational skills and problem solving
• Experience with public facing customer service such as social media, marketing, and/or public relations
• Experience with call center campaigns related to health care initiatives
• Experience with multiple products and markets
• 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 leadership, stakeholders, clients, members, providers, and customers
• Knowledge of MS Office/Excel/Teams
• Attention to detail
• Knowledgeable with Microsoft Office and Social Media platforms
• Ability to multitask
Responds to internal and external customers in a timely and accurate manner, treating them with respect and courtesy
Responds and resolves complex member and provider issues
Conducts thorough research to achieve immediate and accurate responses.
Knowledge of multiple plan/line of business benefits and processes
Compliance work including various privacy forms
Responds to social media, text, email and web portal communications in accordance with contractual and/or compliance requirements
Influencing and educating members on healthcare needs
Conducts outbound calls as required
Documents every interaction accurately (call, mail, email, etc.) data entry
Engages and collaborates with other departments to identify responses to complex inquires
• Responsible and accountable to maintain up to date knowledge of processes and procedures
Pursues learning opportunities to develop and broaden skill set and expertise
Attends meetings and training as scheduled
Demonstrate personal responsibility and accountability by meeting attendance, schedule adherence, quality and production expectations
Flexible and able to meet changing performance objectives consistent with department objectives
Proactively manages member and provider expectations to consistently provide positive member experience
Assists with developing training materials and departmental resources
Assists with or conducts training
Ability to abide by Molina’s policies
Assists with special projects or other duties as assigned
Job Qualifications
REQU I RED ED U C A TI O N :
High School Diploma or GED
REQU I RED E X PE R I E N C E :
Minimum 4 years customer experience in healthcare or equivalent related experience
2 years of experience and knowledge of different social media platforms, text, Outlook and web portal platforms.
Working knowledge of State Medicaid, Medicare and Marketplace programs
Basic understanding of claims processing guidelines
Experience with elevated written and communication skills
Ability to respond through writing on sensitive public facing topics
Working knowledge of Microsoft Office, Sprinklr or other comparable software systems
PR E FE R RED ED U C A TI O N :
Associate’s or Bachelor’s degree
PR E FE R RED E X PE R I E N C E:
Working knowledge of medical insurance billing practices
Public Relations experience
Ability to quickly build rapport
Knowledge of appointment setting/confirmation experience
Experience with multi party calls/liaison/advocate
Organizational brand or marketing experience
Working knowledge of medical terminology, CPT and ICD-10 coding practices
PHY S I C AL DEM A N D S :
W o rki n g en v i r o nm ent is g e n erally f a vo r a b le and li gh t i n g and t e m p erature are a d eq u at e . W o rk is g eneral l y p erf o r m ed in a home or o ff i ce e n v i r o n m ent in w h i c h t h ere is o n l y m i n i m al e x p o su r e to u np leasa n t a nd /o r ha z ar d o u s w o rki n g c o nd iti o n s. M u s t h a v e t h e a b ility t o s i t f o r l o n g p eri o d s. Rea s o n a b le acc om mo d a ti o n s m a y be m a d e to e n a b le in d i v i du als with d i sa b ilities t o p er f o r m t h e e ssential fu n cti o n .
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.
Pay Range: $17.85 - $31.97 / HOURLY
• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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