Rep, Customer Experience III - Outbound (Remote - CST Shift)

$27,893 - $60,445/Yr

Molina Healthcare

Full-time

Remote

Insurance Carriers and Related Activities

About the position

The Rep, Customer Experience III - Outbound role at Molina Healthcare focuses on providing exceptional customer support to members and providers. This position is responsible for resolving issues, addressing needs, and enhancing member and provider experiences through effective communication across various channels. The role emphasizes continuous quality improvement in member/provider engagement and retention, while representing their interests in various operational areas.

Responsibilities

• Provide service support to members and/or providers using contact center communication channels across multiple states and/or products.
• Handle escalated calls on behalf of management.
• Provide excellent customer service for all call center communication channels.
• Accurately document all member/provider communication.
• Work regularly scheduled shifts within operational hours, including overtime and weekends as needed.
• Build rapport and respond to customers compassionately by identifying and exceeding their expectations.
• Listen skillfully, collect relevant information, and determine immediate requests to identify customer needs.
• Achieve individual performance goals in call quality, attendance, and schedule adherence.
• Engage and collaborate with other departments.
• Take ownership of calls/issues and follow through to resolution for customers.
• Support member inquiries regarding benefits, claims, premiums, and complex issues.
• Assist providers with inquiries involving claims, authorizations, appeals, and other complex issues.
• Proficiently handle three or more lines of business for member and provider services.
• Respond to incoming calls from providers on various issues, including complex ones.
• Conduct research for state, legislative, or regulatory inquiries as applicable.
• Gather information to evaluate options and develop solutions.
• Assist with training needs of other employees and new hire classes as needed.
• Conduct member satisfaction assessments and surveys as applicable.

Requirements

• Associate's Degree or equivalent combination of education and experience.
• 3-5 years customer service or sales experience in a fast-paced, high-volume environment.

Nice-to-haves

• Bachelor's Degree or equivalent combination of education and experience.
• 5-7 years of customer service or sales experience.
• Proficient in systems such as Microsoft Office, Genesys, Salesforce, Pega, QNXT, CRM, Verint, Kronos, Microsoft Teams, Video Conferencing, CVS Caremark, Availity, and Molina Provider Portal.
• Broker/Healthcare insurance licensure.

Benefits

• Competitive benefits and compensation package.