Provider Services Rep II (MMS) job - Molina Healthcare - Augusta, ME

Acts as the liaison between the customer, the provider community and other health care representatives. Supports all aspects of the relationship including trouble shooting and client manual/policy knowledge.

Essential Functions

o Handles heavy inbound call volume with knowledge to address more complex concerns from Provider Community.

o Interacts with providers, in a timely and professional manner, including escalating recurring or critical issues to appropriate Team Lead or Manager.

o Navigates through the system with efficiency.

o Meets and retains all quality and production standards set by management and/or customer.

o Handles special projects that include but are not limited to member mail, LTC calls, Nursing Home, Hospice, and mild research, in timely manner.

Knowledge/Skills/Abilities

o Ability to work independently with little to no supervision

o Ability to multi task in a high paced environment and retain information

o Excellent organizational, and verbal and written communication skills

o Excellent time management skills

o Proficient knowledge of Microsoft Office

o Must possess knowledge and skill to support and enable less experienced staff

o Ability to abide by Molina policies

o Ability to maintain attendance to support required quality and quantity of work

o Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

o Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

Job Qualifications

Required Education:

High School Diploma or equivalent GED

Required Experience:

3-5 years Customer Service/Call Center experience in medical claims

Familiarity with Data Input

Proficient knowledge of Microsoft Office

Required Licensure/Certification:

N/A

Preferred Education:

N/A

Preferred Experience:

Medicaid

Medical Claims Processing

Preferred Licensure/Certification:

N/A

Additional Description

To all current Molina employees if you are interested in applying for this position please apply through the

intranet

job listing.

Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.