Patient Service Representative jobs at HCA Healthcare - 31 jobs

The purpose of the Customer Service Representative position is to support the Customer Service Call Center as it relates to physician billing for multiple clients. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Handle a large call volume while ensuring quality customer service and patient satisfaction * issues not resolved during conversation with patient/guarantor * Ability to complete other related customer service duties as assigned SUPERVISORY RESPONSIBILITIES If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position serves as the primary source of communication for patients' billing inquiries. This person must possess the skill to effectively assist patients with sensitive and confidential issues, while understanding our obligation to our clients to collect outstanding patient balances. They should be able to handle multiple tasks along with setting appropriate priorities with client information. * Answer patient calls within the guidelines of call center metric objectives * Ensure appropriate HIPAA compliance guidelines * Adhere to work schedule and follow call center phone procedures * Maintain professionalism and confidentiality Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * High School degree or equivalent required * At least 1 year experience in a medical customer service role preferred * Previous experience in a call center environment preferred * Proficiency in Microsoft Outlook, Excel and Word required * Previous experience with medical billing systems required; GE Centricity or EPIC experience a plus REQUIRED CERTIFICATIONS/LICENSURE Include minimum certification required to perform the job. N/A PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Must be able to work in sitting position, use computer and answer telephone * Ability to travel * Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Office Work Environment * Hospital Work Environment TRAVEL * No travel required Compensation and Benefit Information Compensation * Pay: $14.50 - $21.80 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

The purpose of the Customer Service Representative position is to support the Customer Service Call Center as it relates to physician billing for multiple clients. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Handle a large call volume while ensuring quality customer service and patient satisfaction * issues not resolved during conversation with patient/guarantor * Ability to complete other related customer service duties as assigned SUPERVISORY RESPONSIBILITIES If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position serves as the primary source of communication for patients' billing inquiries. This person must possess the skill to effectively assist patients with sensitive and confidential issues, while understanding our obligation to our clients to collect outstanding patient balances. They should be able to handle multiple tasks along with setting appropriate priorities with client information. * Answer patient calls within the guidelines of call center metric objectives * Ensure appropriate HIPAA compliance guidelines * Adhere to work schedule and follow call center phone procedures * Maintain professionalism and confidentiality Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * High School degree or equivalent required * At least 1 year experience in a medical customer service role preferred * Previous experience in a call center environment preferred * Proficiency in Microsoft Outlook, Excel and Word required * Previous experience with medical billing systems required; GE Centricity or EPIC experience a plus REQUIRED CERTIFICATIONS/LICENSURE Include minimum certification required to perform the job. N/A PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Must be able to work in sitting position, use computer and answer telephone * Ability to travel * Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Office Work Environment * Hospital Work Environment TRAVEL * No travel required Compensation and Benefit Information Compensation * Pay: $14.50 - $21.80 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

The Insurance Verification Representative is responsible for verifying insurance benefits, eligibility, and authorization requirements to ensure accurate billing and reimbursement for procedures and services. This role interacts with physician offices, patients, and internal departments to coordinate insurance approvals, obtain necessary referrals and authorizations, and communicate patient financial responsibilities. The Insurance Verification Representative ensures compliance with payer guidelines and facilitates a smooth scheduling and billing process for patients. This is a REMOTE position Essential Functions Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients to ensure coverage and minimize claim denials. Confirms that the correct insurance package has been loaded into the patient's chart and updates records as needed. Reviews provider schedules in the electronic medical record system to obtain referrals for HMO patients and authorizations for procedures and radiology testing. Works with hospital radiology and scheduling teams to ensure all necessary authorizations are secured for upcoming procedures. Reviews the authorization/referral list in the patient financial system (e.g., Athena) and attaches required authorizations and referrals to pending appointments. Utilizes financial and scheduling systems to generate authorizations, verify patient coverage, and ensure all necessary approvals are documented. Tracks and monitors authorizations and referrals, ensuring compliance with benchmark data and payer requirements. Coordinates with physician offices to resolve issues related to pre-determinations and authorization delays. Contacts patients in advance of procedures to notify them of estimated financial responsibility and available payment options. Assists and provides backup support for other business office positions as needed. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Associate Degree in Healthcare Administration, Business, or a related field preferred 1-2 years of experience in insurance verification, patient access, medical billing, or healthcare financial services required Experience working with electronic medical records (EMR), patient scheduling systems, and insurance payer portals. preferred Knowledge, Skills and Abilities Strong understanding of insurance verification processes, medical benefit plans, and payer authorization requirements. Knowledge of healthcare reimbursement practices, including prior authorization and referral processes. Proficiency in electronic medical records (EMR), financial systems, and patient scheduling software. Excellent communication and customer service skills to interact professionally with patients, physician offices, and payers. Strong attention to detail to ensure accuracy in insurance verification and documentation. Ability to work independently and prioritize tasks in a fast-paced environment. Knowledge of HIPAA regulations and patient confidentiality requirements.

Department Name: Patient Balance Mgmt Work Shift: Varied Job Category: Revenue Cycle Estimated Pay Range: $17.67 - $26.50 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we're constantly improving to make Banner Health the best place to work and receive care. The PFS Customer Service Rep role coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. We work as a team to ensure reimbursement for services in a timely and accurate manner. This position is for our Call Center Team, answering high call-volume and high-level questions regarding patient billing questions. We are currently looking for experienced professionals with strong customer service skills to join our team. Location: Remote Schedule: Part time, 20hrs/wk. Mon-Fri 1:30pm-5:30pm AZ Time Ideal Candidates: Minimum of 1 year experience in Customer Service and/or Call Center, clearly reflected in resume; Minimum of 1 year Healthcare experience in Finance, Revenue Cycle, or Patient Financial Services This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV, WY Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner. CORE FUNCTIONS 1. Responds to incoming calls to provide assistance and excellent customer service to patients, patient families, providers, and other internal and external customers to resolve billing, payment and accounting issues 2. Responsible to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing and PCI compliance. 3. As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company's collection/self-pay policies to ensure maximum reimbursement. 4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients. 5. As assigned, works with walk-in patient's with accounts and processing payments. 6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances. 7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately. 8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members. Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day. NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager. SUPERVISORY RESPONSIBILITIES DIRECTLY REPORTING None MATRIX OR INDIRECT REPORTING None TYPE OF SUPERVISORY RESPONSIBILITIES None Banner Health Leadership will strive to uphold the mission, values, and purpose of the organization. They will serve as role models for staff and act in a people-centered, service excellence-focused, and results-oriented manner. PHYSICAL DEMANDS/ENVIRONMENT FACTORS OE - Typical Office Environment: (Accountant, Administrative Assistant, Consultant, Program Manager) Requires extensive sitting with periodic standing and walking. May be required to lift up to 20 pounds. Requires significant use of personal computer, phone and general office equipment. Needs adequate visual acuity, ability to grasp and handle objects. Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone. May require off-site travel. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge. Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Strong knowledge of insurance plans with deductibles and co-insurances. Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required. PREFERRED QUALIFICATIONS Work experience with the Company's systems and processes is preferred. Previous cash collections experience is preferred. Bi-lingual a plus. Additional related education and/or experience preferred. DATE APPROVED 03/30/2025 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy

is February.** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. **KNOWLEDGE/SKILLS/ABILITIES** This role serves as the primary point of contact between Molina Health plan and the Provider community that serves Molina members. It's an external-facing, field-based position requiring a high degree of job knowledge, communication, and organizational skills to successfully engage high volume, high visibility providers (including senior leaders and physicians) to ensure provider satisfaction, education on key Molina initiatives, and improved coordination and partnership. + Under minimal direction, works directly with the Plan's external providers to educate, advocate, and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service. + Conducts regular provider site visits within assigned region/service area. Determines own daily or weekly schedule, as needed to meet or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to determine, for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members. + Provides on-the-spot training and education as needed, which may include counseling providers diplomatically, while retaining a positive working relationship. + Independently troubleshoots problems as they arise, making an assessment when escalation to a Senior Representative, Supervisor, or another Molina department is needed. Takes initiative in preventing and resolving issues between the provider and the Plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters. + Initiates, coordinates, and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians. Such meetings would occur to discuss and resolve issues related to utilization management, pharmacy, quality of care, and correct coding, for example. + Independently delivers training and presentations to assigned providers and their staff, answering questions that come up on behalf of the Health plan. May also deliver training and presentations to larger groups, such as leaders and management of provider offices (including large multispecialty groups or health systems, executive level decision makers, Association meetings, and JOC's). + Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives. Examples of such initiatives include administrative cost effectiveness, member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, etc.). + Trains other Provider Services Representatives as appropriate. + Role requires 80%+ same-day or overnight travel. (Extent of overnight travel will depend on the specific Health Plan and its service area.). **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. **Required Experience** + 2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's Degree. **Preferred Experience** + 5 years' experience in managed healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. 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: $21.65 - $46.42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Our Benefits: As an Insurance Specialist at Community Health Systems (CHS) - Shared Business Operations, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including: 80 hours of PTO 7 paid holidays Employee Incentive Program (ICP) Group Medical, Dental, & Vision Educational Assistance 401(k) Plan Sick Time Life Insurance/Accidental Death and Dismemberment Long-Term and Short Term Disability Medical and Child Care Flexible Spending Accounts Employee Assistance Program (EAP) Job Summary The Insurance Specialist I is responsible for verifying insurance eligibility and benefits, ensuring authorization requirements are met, and completing pre-registration processes for scheduled outpatient and inpatient services. This role ensures compliance with payor guidelines and provides timely and accurate communication with patients, providers, and medical office staff. The Insurance Specialist I supports the financial clearance process by educating patients on insurance benefits and financial responsibilities while maintaining high standards of accuracy and professionalism. As an Insurance Specialist I at Community Health Systems (CHS) - SSC Sarasota, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical insurance, dental insurance, vision insurance, PTO, 401K, sick time, holidays, and bonus where eligible. Essential Functions: Verifies insurance eligibility and benefits for scheduled and unscheduled services to ensure coverage and compliance with payor requirements. Calculates and communicates the patient's estimated financial responsibility for scheduled services. Identifies and ensures authorization and referral requirements are met in accordance with payor guidelines. Validates and documents all authorizations and referrals according to established policies. Reviews and determines the medical necessity of scheduled services based on payor criteria. Accurately documents and maintains all required records and communications in compliance with organizational standards. Communicates effectively and professionally with patients, physicians, and medical office staff to resolve inquiries and ensure adherence to payor requirements. Educates patients on insurance coverage, benefits, and financial responsibility, ensuring clear understanding. Processes and indexes incoming orders promptly and ensures compliance with documentation standards. Provides timely notification of admission or observation status per payor guidelines for inpatient and observation services. Performs other duties as assigned. Complies with all policies and standards. Weekend availability is required for this specific role. This is a remote position. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Required: Weekend availability is required for this specific role. Education: H.S. Diploma or GED Experience: 0-1 years of experience in insurance verification, medical billing, or healthcare revenue cycle Knowledge, Skills and Abilities: Strong knowledge of insurance plans, authorization requirements, and medical necessity guidelines. Proficiency in Microsoft Office Suite and healthcare information systems (e.g., EMR, eligibility portals). Excellent attention to detail and organizational skills. Strong communication and interpersonal skills to interact effectively with patients and healthcare professionals. Ability to work in a fast-paced environment and manage multiple priorities effectively. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Sarasota SSC operates in support of our hospitals and patients and our commitment is to provide them with exemplary revenue cycle services defined by outstanding customer service and superior revenue cycle performance. SSC Sarasota supports facilities located primarily in Florida, Georgia, Indiana, and Pennsylvania. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. INDSSFLRCSC

is February.** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. **KNOWLEDGE/SKILLS/ABILITIES** This role serves as the primary point of contact between Molina Health plan and the Provider community that serves Molina members. It's an external-facing, field-based position requiring a high degree of job knowledge, communication, and organizational skills to successfully engage high volume, high visibility providers (including senior leaders and physicians) to ensure provider satisfaction, education on key Molina initiatives, and improved coordination and partnership. + Under minimal direction, works directly with the Plan's external providers to educate, advocate, and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service. + Conducts regular provider site visits within assigned region/service area. Determines own daily or weekly schedule, as needed to meet or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to determine, for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members. + Provides on-the-spot training and education as needed, which may include counseling providers diplomatically, while retaining a positive working relationship. + Independently troubleshoots problems as they arise, making an assessment when escalation to a Senior Representative, Supervisor, or another Molina department is needed. Takes initiative in preventing and resolving issues between the provider and the Plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters. + Initiates, coordinates, and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians. Such meetings would occur to discuss and resolve issues related to utilization management, pharmacy, quality of care, and correct coding, for example. + Independently delivers training and presentations to assigned providers and their staff, answering questions that come up on behalf of the Health plan. May also deliver training and presentations to larger groups, such as leaders and management of provider offices (including large multispecialty groups or health systems, executive level decision makers, Association meetings, and JOC's). + Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives. Examples of such initiatives include administrative cost effectiveness, member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, etc.). + Trains other Provider Services Representatives as appropriate. + Role requires 80%+ same-day or overnight travel. (Extent of overnight travel will depend on the specific Health Plan and its service area.). **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. **Required Experience** + 2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's Degree. **Preferred Experience** + 5 years' experience in managed healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. 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: $21.65 - $46.42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.