Support Representative jobs at HCA Healthcare - 45 jobs

Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. Job Duties * Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. * Handles escalated calls on behalf of management. * Provides excellent customer service for all call center communication channels. * Accurately documents all member/provider communication * Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. * Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. * Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. * Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. * Engages and collaborates with other departments. * Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. * Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. * Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. * Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. * Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. * Completes research for state, legislative or regulatory inquiries as applicable. * Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. * Achieves individual performance goals as it relates to call center objectives. * Proactively engages and collaborates with other departments as required. * Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. * Assists with formal training needs of other employees along with new hire or training classes as needed. * Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. * Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. * Supports other inquiry areas including the most complex issues. * Conducts initial research and works to immediately resolve issues. * Appropriately escalates issues based on established risk criteria. * Recommends and implements programs to support member needs. * Resolves member inquiries and complaints fairly and effectively to ensure member retention. * Responds to incoming calls from members and providers. * Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs * Assist other retention or inbound functions as dictated by service level requirements * Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 3-5 years customer service or sales experience in a fast paced, high volume environment PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 5-7 years Proficient in systems utilized: * Microsoft Office * Genesys * Salesforce * Pega * QNXT * CRM * Verint * Kronos * Microsoft Teams * Video Conferencing * CVS Caremark * Availity * Molina Provider Portal * Others as required by line of business or state PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Broker/Healthcare insurance licensure 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 - $34.88 / 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 support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. **Job Duties** - Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. - Handles escalated calls on behalf of management. - Provides excellent customer service for all call center communication channels. - Accurately documents all member/provider communication - Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. - Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. - Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. - Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. - Engages and collaborates with other departments. - Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. - Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. - Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. - Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. - Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. - Completes research for state, legislative or regulatory inquiries as applicable. - Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. - Achieves individual performance goals as it relates to call center objectives. - Proactively engages and collaborates with other departments as required. - Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. - Assists with formal training needs of other employees along with new hire or training classes as needed. - Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. - Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. - Supports other inquiry areas including the most complex issues. - Conducts initial research and works to immediately resolve issues. - Appropriately escalates issues based on established risk criteria. - Recommends and implements programs to support member needs. - Resolves member inquiries and complaints fairly and effectively to ensure member retention. - Responds to incoming calls from members and providers. - Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs - Assist other retention or inbound functions as dictated by service level requirements - Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 3-5 years customer service or sales experience in a fast paced, high volume environment **PREFERRED EDUCATION** : Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE** : 5-7 years Proficient in systems utilized: + Microsoft Office + Genesys + Salesforce + Pega + QNXT + CRM + Verint + Kronos + Microsoft Teams + Video Conferencing + CVS Caremark + Availity + Molina Provider Portal + Others as required by line of business or state **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Broker/Healthcare insurance licensure 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 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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 support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. Job Duties * Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. * Handles escalated calls on behalf of management. * Provides excellent customer service for all call center communication channels. * Accurately documents all member/provider communication * Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. * Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. * Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. * Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. * Engages and collaborates with other departments. * Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. * Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. * Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. * Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. * Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. * Completes research for state, legislative or regulatory inquiries as applicable. * Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. * Achieves individual performance goals as it relates to call center objectives. * Proactively engages and collaborates with other departments as required. * Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. * Assists with formal training needs of other employees along with new hire or training classes as needed. * Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. * Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. * Supports other inquiry areas including the most complex issues. * Conducts initial research and works to immediately resolve issues. * Appropriately escalates issues based on established risk criteria. * Recommends and implements programs to support member needs. * Resolves member inquiries and complaints fairly and effectively to ensure member retention. * Responds to incoming calls from members and providers. * Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs * Assist other retention or inbound functions as dictated by service level requirements * Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 3-5 years customer service or sales experience in a fast paced, high volume environment PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 5-7 years Proficient in systems utilized: * Microsoft Office * Genesys * Salesforce * Pega * QNXT * CRM * Verint * Kronos * Microsoft Teams * Video Conferencing * CVS Caremark * Availity * Molina Provider Portal * Others as required by line of business or state PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Broker/Healthcare insurance licensure 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 - $34.88 / 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 support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. **Job Duties** - Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. - Handles escalated calls on behalf of management. - Provides excellent customer service for all call center communication channels. - Accurately documents all member/provider communication - Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. - Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. - Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. - Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. - Engages and collaborates with other departments. - Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. - Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. - Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. - Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. - Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. - Completes research for state, legislative or regulatory inquiries as applicable. - Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. - Achieves individual performance goals as it relates to call center objectives. - Proactively engages and collaborates with other departments as required. - Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. - Assists with formal training needs of other employees along with new hire or training classes as needed. - Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. - Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. - Supports other inquiry areas including the most complex issues. - Conducts initial research and works to immediately resolve issues. - Appropriately escalates issues based on established risk criteria. - Recommends and implements programs to support member needs. - Resolves member inquiries and complaints fairly and effectively to ensure member retention. - Responds to incoming calls from members and providers. - Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs - Assist other retention or inbound functions as dictated by service level requirements - Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 3-5 years customer service or sales experience in a fast paced, high volume environment **PREFERRED EDUCATION** : Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE** : 5-7 years Proficient in systems utilized: + Microsoft Office + Genesys + Salesforce + Pega + QNXT + CRM + Verint + Kronos + Microsoft Teams + Video Conferencing + CVS Caremark + Availity + Molina Provider Portal + Others as required by line of business or state **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Broker/Healthcare insurance licensure 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 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. Job Duties * Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. * Handles escalated calls on behalf of management. * Provides excellent customer service for all call center communication channels. * Accurately documents all member/provider communication * Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. * Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. * Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. * Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. * Engages and collaborates with other departments. * Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. * Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. * Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. * Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. * Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. * Completes research for state, legislative or regulatory inquiries as applicable. * Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. * Achieves individual performance goals as it relates to call center objectives. * Proactively engages and collaborates with other departments as required. * Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. * Assists with formal training needs of other employees along with new hire or training classes as needed. * Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. * Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. * Supports other inquiry areas including the most complex issues. * Conducts initial research and works to immediately resolve issues. * Appropriately escalates issues based on established risk criteria. * Recommends and implements programs to support member needs. * Resolves member inquiries and complaints fairly and effectively to ensure member retention. * Responds to incoming calls from members and providers. * Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs * Assist other retention or inbound functions as dictated by service level requirements * Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 3-5 years customer service or sales experience in a fast paced, high volume environment PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 5-7 years Proficient in systems utilized: * Microsoft Office * Genesys * Salesforce * Pega * QNXT * CRM * Verint * Kronos * Microsoft Teams * Video Conferencing * CVS Caremark * Availity * Molina Provider Portal * Others as required by line of business or state PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Broker/Healthcare insurance licensure 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 - $34.88 / 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 support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. Job Duties * Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. * Handles escalated calls on behalf of management. * Provides excellent customer service for all call center communication channels. * Accurately documents all member/provider communication * Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. * Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. * Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. * Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. * Engages and collaborates with other departments. * Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. * Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. * Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. * Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. * Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. * Completes research for state, legislative or regulatory inquiries as applicable. * Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. * Achieves individual performance goals as it relates to call center objectives. * Proactively engages and collaborates with other departments as required. * Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. * Assists with formal training needs of other employees along with new hire or training classes as needed. * Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. * Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. * Supports other inquiry areas including the most complex issues. * Conducts initial research and works to immediately resolve issues. * Appropriately escalates issues based on established risk criteria. * Recommends and implements programs to support member needs. * Resolves member inquiries and complaints fairly and effectively to ensure member retention. * Responds to incoming calls from members and providers. * Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs * Assist other retention or inbound functions as dictated by service level requirements * Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 3-5 years customer service or sales experience in a fast paced, high volume environment PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 5-7 years Proficient in systems utilized: * Microsoft Office * Genesys * Salesforce * Pega * QNXT * CRM * Verint * Kronos * Microsoft Teams * Video Conferencing * CVS Caremark * Availity * Molina Provider Portal * Others as required by line of business or state PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Broker/Healthcare insurance licensure 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 - $34.88 / 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 support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. **Job Duties** - Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. - Handles escalated calls on behalf of management. - Provides excellent customer service for all call center communication channels. - Accurately documents all member/provider communication - Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. - Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. - Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. - Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. - Engages and collaborates with other departments. - Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. - Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. - Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. - Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. - Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. - Completes research for state, legislative or regulatory inquiries as applicable. - Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. - Achieves individual performance goals as it relates to call center objectives. - Proactively engages and collaborates with other departments as required. - Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. - Assists with formal training needs of other employees along with new hire or training classes as needed. - Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. - Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. - Supports other inquiry areas including the most complex issues. - Conducts initial research and works to immediately resolve issues. - Appropriately escalates issues based on established risk criteria. - Recommends and implements programs to support member needs. - Resolves member inquiries and complaints fairly and effectively to ensure member retention. - Responds to incoming calls from members and providers. - Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs - Assist other retention or inbound functions as dictated by service level requirements - Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 3-5 years customer service or sales experience in a fast paced, high volume environment **PREFERRED EDUCATION** : Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE** : 5-7 years Proficient in systems utilized: + Microsoft Office + Genesys + Salesforce + Pega + QNXT + CRM + Verint + Kronos + Microsoft Teams + Video Conferencing + CVS Caremark + Availity + Molina Provider Portal + Others as required by line of business or state **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Broker/Healthcare insurance licensure 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 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. **Job Duties** - Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. - Handles escalated calls on behalf of management. - Provides excellent customer service for all call center communication channels. - Accurately documents all member/provider communication - Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. - Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. - Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. - Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. - Engages and collaborates with other departments. - Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. - Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. - Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. - Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. - Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. - Completes research for state, legislative or regulatory inquiries as applicable. - Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. - Achieves individual performance goals as it relates to call center objectives. - Proactively engages and collaborates with other departments as required. - Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. - Assists with formal training needs of other employees along with new hire or training classes as needed. - Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. - Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. - Supports other inquiry areas including the most complex issues. - Conducts initial research and works to immediately resolve issues. - Appropriately escalates issues based on established risk criteria. - Recommends and implements programs to support member needs. - Resolves member inquiries and complaints fairly and effectively to ensure member retention. - Responds to incoming calls from members and providers. - Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs - Assist other retention or inbound functions as dictated by service level requirements - Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 3-5 years customer service or sales experience in a fast paced, high volume environment **PREFERRED EDUCATION** : Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE** : 5-7 years Proficient in systems utilized: + Microsoft Office + Genesys + Salesforce + Pega + QNXT + CRM + Verint + Kronos + Microsoft Teams + Video Conferencing + CVS Caremark + Availity + Molina Provider Portal + Others as required by line of business or state **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Broker/Healthcare insurance licensure 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 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. Job Duties * Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. * Handles escalated calls on behalf of management. * Provides excellent customer service for all call center communication channels. * Accurately documents all member/provider communication * Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. * Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. * Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. * Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. * Engages and collaborates with other departments. * Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. * Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. * Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. * Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. * Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. * Completes research for state, legislative or regulatory inquiries as applicable. * Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. * Achieves individual performance goals as it relates to call center objectives. * Proactively engages and collaborates with other departments as required. * Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. * Assists with formal training needs of other employees along with new hire or training classes as needed. * Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. * Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. * Supports other inquiry areas including the most complex issues. * Conducts initial research and works to immediately resolve issues. * Appropriately escalates issues based on established risk criteria. * Recommends and implements programs to support member needs. * Resolves member inquiries and complaints fairly and effectively to ensure member retention. * Responds to incoming calls from members and providers. * Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs * Assist other retention or inbound functions as dictated by service level requirements * Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 3-5 years customer service or sales experience in a fast paced, high volume environment PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 5-7 years Proficient in systems utilized: * Microsoft Office * Genesys * Salesforce * Pega * QNXT * CRM * Verint * Kronos * Microsoft Teams * Video Conferencing * CVS Caremark * Availity * Molina Provider Portal * Others as required by line of business or state PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Broker/Healthcare insurance licensure 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 - $34.88 / 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 support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. **Job Duties** - Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. - Handles escalated calls on behalf of management. - Provides excellent customer service for all call center communication channels. - Accurately documents all member/provider communication - Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. - Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. - Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. - Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. - Engages and collaborates with other departments. - Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. - Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. - Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. - Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. - Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. - Completes research for state, legislative or regulatory inquiries as applicable. - Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. - Achieves individual performance goals as it relates to call center objectives. - Proactively engages and collaborates with other departments as required. - Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. - Assists with formal training needs of other employees along with new hire or training classes as needed. - Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. - Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. - Supports other inquiry areas including the most complex issues. - Conducts initial research and works to immediately resolve issues. - Appropriately escalates issues based on established risk criteria. - Recommends and implements programs to support member needs. - Resolves member inquiries and complaints fairly and effectively to ensure member retention. - Responds to incoming calls from members and providers. - Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs - Assist other retention or inbound functions as dictated by service level requirements - Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 3-5 years customer service or sales experience in a fast paced, high volume environment **PREFERRED EDUCATION** : Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE** : 5-7 years Proficient in systems utilized: + Microsoft Office + Genesys + Salesforce + Pega + QNXT + CRM + Verint + Kronos + Microsoft Teams + Video Conferencing + CVS Caremark + Availity + Molina Provider Portal + Others as required by line of business or state **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Broker/Healthcare insurance licensure 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 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. Job Duties * Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. * Handles escalated calls on behalf of management. * Provides excellent customer service for all call center communication channels. * Accurately documents all member/provider communication * Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. * Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. * Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. * Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. * Engages and collaborates with other departments. * Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. * Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. * Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. * Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. * Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. * Completes research for state, legislative or regulatory inquiries as applicable. * Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. * Achieves individual performance goals as it relates to call center objectives. * Proactively engages and collaborates with other departments as required. * Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. * Assists with formal training needs of other employees along with new hire or training classes as needed. * Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. * Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. * Supports other inquiry areas including the most complex issues. * Conducts initial research and works to immediately resolve issues. * Appropriately escalates issues based on established risk criteria. * Recommends and implements programs to support member needs. * Resolves member inquiries and complaints fairly and effectively to ensure member retention. * Responds to incoming calls from members and providers. * Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs * Assist other retention or inbound functions as dictated by service level requirements * Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 3-5 years customer service or sales experience in a fast paced, high volume environment PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 5-7 years Proficient in systems utilized: * Microsoft Office * Genesys * Salesforce * Pega * QNXT * CRM * Verint * Kronos * Microsoft Teams * Video Conferencing * CVS Caremark * Availity * Molina Provider Portal * Others as required by line of business or state PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Broker/Healthcare insurance licensure 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 - $34.88 / 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 support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. Responsible for continuous quality improvements regarding member/provider engagement and retention. Represents Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance of Member/Provider Materials. **Job Duties** - Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies opportunities to maintain and increase member/provider relationships and engagement. - Handles escalated calls on behalf of management. - Provides excellent customer service for all call center communication channels. - Accurately documents all member/provider communication - Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed. - Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations. - Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the customer's needs. - Achieves individual performance goals established for this position in the areas of call quality, attendance and scheduled adherence. - Engages and collaborates with other departments. - Demonstrates personal responsibility and accountability by taking ownership of the call/ issue and following it through to resolution, on behalf of the customer, in real time or through timely follow up with the customer. - Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria. - Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing and other areas including the most complex issues. Conducts initial research and works to immediate resolve issues. Appropriately escalates issues based on established risk criteria. - Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services and member retention. - Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. - Completes research for state, legislative or regulatory inquiries as applicable. - Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. - Achieves individual performance goals as it relates to call center objectives. - Proactively engages and collaborates with other departments as required. - Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. - Assists with formal training needs of other employees along with new hire or training classes as needed. - Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. - Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing and other provider related issues. - Supports other inquiry areas including the most complex issues. - Conducts initial research and works to immediately resolve issues. - Appropriately escalates issues based on established risk criteria. - Recommends and implements programs to support member needs. - Resolves member inquiries and complaints fairly and effectively to ensure member retention. - Responds to incoming calls from members and providers. - Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs - Assist other retention or inbound functions as dictated by service level requirements - Remains professional & courteous in verbal & written communications, utilizing concise & effective language at all times. **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 3-5 years customer service or sales experience in a fast paced, high volume environment **PREFERRED EDUCATION** : Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE** : 5-7 years Proficient in systems utilized: + Microsoft Office + Genesys + Salesforce + Pega + QNXT + CRM + Verint + Kronos + Microsoft Teams + Video Conferencing + CVS Caremark + Availity + Molina Provider Portal + Others as required by line of business or state **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Broker/Healthcare insurance licensure 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 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

The Customer Service Representative I serves as the initial point of contact for customers, addressing inquiries, resolving issues, and delivering high-quality service to ensure a positive customer experience. This entry-level role requires excellent communication skills, attention to detail, and the ability to manage a variety of customer requests through multiple channels, including phone, email, and chat. The Representative works in a performance-driven environment, adhering to established service metrics and standards, while collaborating with other departments to ensure timely and effective resolution of customer concerns. Essential Functions Responds to customer inquiries through phone, email, chat, or other communication channels, providing accurate and timely information. Clarifies and resolves customer issues by identifying their needs, determining root causes, and implementing effective solutions. Escalates complex or unresolved issues to appropriate team members or departments, ensuring prompt follow-up and resolution. Provides triage support for common issues related to platforms, applications, and back-office processes. Documents all interactions accurately and thoroughly in the customer relationship management (CRM) system, ensuring detailed records of inquiries and resolutions. Adheres to quality standards and key performance indicators (KPIs), including productivity, response times, and customer satisfaction ratings. Delivers exceptional customer service by maintaining professionalism, patience, and a customer-focused attitude in all interactions. Contributes to a team-oriented work environment by sharing insights, offering assistance, and collaborating effectively with peers and supervisors. 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 or some college coursework in a related field preferred 1-2 years of customer service experience required, preferably in a call center or help desk environment required Familiarity with CRM software and customer service tools preferred Knowledge, Skills and Abilities Strong verbal and written communication skills, with the ability to clearly convey information and resolve customer concerns. Proficient in using computer systems, including Microsoft Office Suite and CRM platforms. Excellent problem-solving and critical-thinking abilities. Ability to manage multiple tasks and prioritize effectively in a fast-paced environment. Detail-oriented with a strong focus on accuracy and quality. Demonstrated ability to work independently and as part of a team. Strong interpersonal skills and the ability to build rapport with customers and colleagues.

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

The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. Representative will need to effectively follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities. Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance is preferable. An effective revenue cycle process is achieved with working as part of a dynamic team and the ability to adapt and grow in an environment where work assignments may change frequently while resolving accounts with minimal assistance. Representative must be able to work independently as well as work closely with management and team to take appropriate steps to resolve an account. Team member should possess the following: * Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys and team members as needed. * Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions * Access payer websites and discern pertinent data to resolve accounts * Utilize all available job aids provided for appropriateness in Patient Accounting processes * Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account * Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership * Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities * Provide support for team members that may be absent or backlogged ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Researches each account using company patient accounting applications and internet resources that are made available. Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online. Problem solves issues and creates resolution that will bring in revenue eliminating re-work. Updates plan IDs, adjusts patient or payor demographic/insurance information, notates account in detail, identifies payor issues and trends and solves re-coup issues. Requests additional information from patients, medical records, and other needed documentation upon request from payors. Reviews contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed. Takes appropriate action to bring about account resolution timely or opens a dispute record to have the account further researched and substantiated for continued collection. Maintains desk inventory to remain current without backlog while achieving productivity and quality standards. * Perform special projects and other duties as needed. Assists with special projects as assigned, documents, findings, and communicates results. * Recognizes potential delays and trends with payors such as corrective actions and responds to avoid A/R aging. Escalates payment delays/ problem aged account timely to Supervisor. * Participate and attend meetings, training seminars and in-services to develop job knowledge. * Respond timely to emails and telephone messages as appropriate. * Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors. 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. 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. * Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections) procedures and policies * Intermediate skill in Microsoft Office (Word, Excel) * Ability to learn hospital systems - ACE, VI Web, IMaCS, OnDemand quickly and fluently * Ability to communicate in a clear and professional manner * Must have good oral and written skills * Strong interpersonal skills * Above average analytical and critical thinking skills * Ability to make sound decisions * Has a full understanding of the Commercial, Managed Care, Medicare and Medicaid collections, Intermediate knowledge of Managed Care contracts, Contract Language and Federal and State requirements for government payors * Familiar with terms such as HMO, PPO, IPA and Capitation and how these payors process claims. * Intermediate understanding of EOB. * Intermediate understanding of Hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms. * Ability to problem solve, prioritize duties and follow-through completely with assigned tasks. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * High School diploma or equivalent. Some college coursework in business administration or accounting preferred * 1-4 years medical claims and/or hospital collections experience * Minimum typing requirement of 45 wpm 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. * Office/Team Work Environment * Ability to sit and work at a computer terminal for extended periods of time 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. * Call Center environment with multiple workstations in close proximity As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $15.80 - $23.70 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. **********

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. 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.

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. 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.