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

REQUIRED EDUCATION:

High School Diploma or GED                                                                                                                                                                                                                 

REQUIRED EXPERIENCE: 

• 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