Patient Service Representative jobs at Tenet Healthcare - 40 jobs

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

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

Molina Healthcare is hiring a Pharmacy Customer Service Representative. This role is remote for those who live in Florida only. Bilingual- Spanish speaking is needed. Our agents assist with all Medicaid member Pharmacy-related calls. You will assist the members with obtaining their medications. This is a pharmacy call center environment focused on first call resolution and the member's experience. Pharmacy Reps will be taking calls for the state of FL. Must be bilingual, and live in the state of FL. Shift times will be Monday through Friday 9:00 AM - 5:30 or 9:30 - 6:00, or 10:00-6:30 EST, all dependent on business needs. Essential Job Duties Provides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. Provides coordination and processing of pharmacy prior authorization requests and/or appeals. Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. Assists members and providers with initiating verbal and written coverage determinations and appeals. Records calls accurately within the pharmacy call tracking system. Maintains established pharmacy call quality and quantity standards. Interacts with appropriate primary care providers to ensure member registry is current and accurate. Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. Excellent customer service skills. Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. Ability to multi-task applications while speaking with members. Ability to multi-task applications while speaking with members. Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. Ability to meet established deadlines. Ability to function independently and manage multiple projects. Excellent verbal and written communication skills, including excellent phone etiquette. Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Same Posting Description for Internal and External Candidates

Responsibilities Independence Physician Management (IPM), is a subsidiary of Universal Health Services, Inc (UHS). IPM was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. The Referral and Registration Representative provides accurate and efficient Referral and Registration Services on behalf of its customers, UHS's Acute Care Hospitals and Physician Networks. Services provided include, but are not limited to, providing physician referral services, class and event registrations, service line referrals, providing general information, and facilitating appointments with physicians. Services provided support the financial health of its customers. Continuously practice the Standards of UHS Service Excellence program in all job-related functions. Hours: 11:30am -8:00pm, Monday-Friday Remote opportunity * Maintains accurate records within a shared database. * Processes inbound Physician Referral Calls. Assists callers by helping to match them with doctors and facilitates scheduling appointments. * Processes inbound calls for registration in hospital seminars, screenings and education classes. * Processes digital requests for physician referrals. * Contributes to team goals and achieves individual goals. * Collects and accurately documents caller demographics. * Interacts appropriately with physician's office staff. Qualifications High school diploma required with a minimum of 1-3 years experience required. Associates degree preferred. Job Requirements: * Customer service experience. * Medical terminology/health insurance navigation preferred. * Phone etiquette. * Strong communication skills verbal and written. * Medical terminology a plus. * Strong desire to work within a team structure. * Ability to return successful results when conducting internet searches. * Call/contact center experience a plus. * Bilingual a plus. * Scheduled hours are 11:30am to 8:00pm Monday - Friday. As an IPM employee you will be part of a first class organization offering: * A challenging and rewarding work environment * Competitive Compensation & Generous Paid Time Off * Excellent Medical, Dental, Vision and Prescription Drug Plans * 401(K) with company match and much more! Independence Shared Services is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee via email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of Independence Shared Services. No fee will be paid in the event the candidate is hired as a result of the referral or through other means. About Universal Health Services One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $13.4 billion in 2022. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. *********** EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: ************************* or *************** Pay Transparency To encourage pay transparency, promote pay equity, and proactively address regulations, UHS and all our subsidiaries will comply with all applicable state or local laws or regulations which require employers to provide wage or salary range information to job applicants and employees. A posted salary range applies to the current job posting. Salary offers may be based on key factors such as education and related experience.

Department Name: Patient Contact Ctr Imaging Work Shift: Day Job Category: Marketing and Communications Estimated Pay Range: $19.06 - $28.60 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Health care is constantly changing, and at Banner Health, we are at the front of that change. We are leading health care to make the experience the best it can be. We want to change the lives of those in our care - and the people who choose to take on this challenge. If changing health care for the better sounds like something you want to be part of, we want to hear from you. We are seeking candidates who are motivated and enthusiastic to be part of a dynamic team of Health Schedulers. Within this position you will be responsible for answering inbound calls, scheduling, rescheduling and canceling patient appointments as required. Answering patients' questions regarding basic medical questions and procedures. Providing instructions to patients to ensure that they are prepared for examinations and procedures as well as confirming patient appointments. You must be able to communicate well with our patients and provide extraordinary customer service. There is room for growth and this role offers great stability. Our positions are REMOTE and you can work in any Banner approved states. A successful candidate should have a designated area away from distractions to complete this job, attend all training sessions, have established internet connection and able to complete a hardwired internet connection. This position also requires someone who is comfortable working with multiple scheduling systems at a time and navigate through the systems effortlessly while staying organized and viewing 8 or more windows at a time. This is a high-volume call center that requires you to be on the phone back-to-back handling inbound calls of 50+. You may be asked to assist/ cross train in other scheduling departments when needed. Call Center, Health Care, Front Desk, Receptionist OR Customer Service highly desired. Full Time Shifts: Will vary between the hours of 6:00am-7:00pm, Monday through Friday, depending on the department needs. Saturday 5-hour shift may also be required from 8am-1pm for some departments. Departments: Hospital Imaging Centralized Scheduling, Banner Imaging, Primary Care, MD Anderson Cancer Center and Specialties such as Orthro, Sports Meds, Urology, Neurology, Peds etc.…. Openings: We currently have a few openings for each department which will be discussed during the interview process. Training: Remote- M-F 8am-4:30pm, this can change depending on department needs, equipment will be provided. Cameras are required during trainings and meetings. Shifts are not flexible to accommodate personal appointments during the day. This is a call center role that requires you to work scheduled hours due to business needs. 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 is responsible for scheduling across the system for physicians, medical facilities and medical practices by coordinating all aspects of scheduling including, but not limiting to, facility resources, physicians, authorizations, insurance verification, benefits and setting payment expectations to ensure an exceptional customer experience at each point of service. Using a broad understanding of customer engagement strategies, clinical procedures and company facilities, this position provides accurate and timely information to create an experience that is easy, empathetic and differentiated in the marketplace. CORE FUNCTIONS 1. Schedules medical appointments through coordination of patients, providers, facility resources, ancillary staff, records, referrals, authorizations and payers. Receives and initiates calls to/from patients, providers, provider offices and facilities, while following all established scheduling procedures and protocols to ensure patients receive the care they need, when and where they need it. 2. Effectively schedules appointments, tests and/or procedures leveraging various electronic medical record / scheduling software systems according to protocols established by clinical staff and scheduling standards. Identifies alternative schedule solutions in the event patient's preference is not available, while adhering to procedures and protocols and ensuring patient safety. 3. Obtains patient demographics, insurance information and necessary documents required to secure authorizations, referrals, or other data as determined by various facilities and insurance carriers. Responsible for obtaining and properly documenting all necessary and accurate data during the intake/registration process. Acquires and documents pertinent patient medical information in accordance with procedural guidelines. 4. Provides patients with information, pre and post-test instruction, provides location of appointment and directions. This position answers questions as necessary within guidelines and protocols. Refers questions to medical offices as appropriate. Ensures patient has “no surprises” at point of service by setting payment expectations, as well as, providing estimated payment detail where applicable. 5. Effectively communicates and builds impactful relationships through written, digital and verbal channels with patients, facilities, providers and other clinical colleagues to ensure an easy, empathetic, solution-orientated patient experience, included but not limited to phone, chat, email, electronic medical record messaging and other digital channels. Anticipates patient and provider needs and responds accordingly. 6. Solicits, labels, stores and manages scanned documents and orders received from physician offices in the document imaging software system. Ensures that all appropriate documents are received prior to appointments and ensures that orders are compliant with each facility's policy. 7. Where applicable, collects pre-payments and verifies insurance coverage to ensure “no surprises” and enable patient ease. 8. Services inbound and outbound customer and staff communications for all facilities in the states in which they operate. Works with various departments and staff to provide accurate managed care information. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge. Requires skills and abilities typically attained with minimum of 1 or more years of customer service or related experience in a healthcare setting, such as medical office/clinic or hospital scheduling. Other acceptable experience includes lab, medical transcription, medical assistant or receptionist in a medical setting or other equivalent experience. Demonstrated ability to provide essential customer service and knowledge in a high paced inbound contact center environment Ability to use technology tools to research and obtain accurate information to respond to customer inquiries via incoming calls, emails and/or instant messaging/chat avenues while maintaining a professional solutions and service-oriented demeanor at all times. Effective ability to build customer loyalty through positive customer interactions and provide an easy experience. Demonstrated ability to utilize computer and typing skills. Excellent interpersonal and communication skills to maintain a positive and helpful attitude with customers, providers and clinic operations. Must have the ability to follow oral and written directions as they relate to the functions listed above. Must have the ability to acquire and utilize a sound knowledge of the company's customer information systems. Must possess excellent organizational and time management skills. Accurate and efficient keyboarding skills, the ability to work effectively with common office software are required. Requires effective teamwork skills and the ability to meet deadlines and productivity standards. PREFERRED QUALIFICATIONS Experience in an in-bound call center or scheduler in a practice management environment preferred. Knowledge of payor contract terms and processes preferred. Some level of familiarity with medical terminology strongly preferred. Knowledge of payor contract terms and processes is preferred. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy

The Bilingual Scheduling Specialist is responsible for supporting scheduling functions across assigned hospitals, clinics, or centralized patient access centers and will be the first point of contact for patients. This focuses on managing patient appointment scheduling, helping with general patient needs, and accurately communicating patient needs to the clinical staff through centralized call center operations. The Scheduling Specialist ensures communications and appointments are accurate, timely, and compliant with organizational policies while fostering effective communication with clinicians, patients, and leadership. The ideal candidate will be bilingual in English and Spanish. As a Scheduling Specialist at Community Health Systems (CHS) - Patient Access Center, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental, and vision insurance, paid time off (PTO), 401(k) with company match, tuition reimbursement, and more Essential Functions Completes accurate patient appointment scheduling across multiple clinics, depending on assignment. Receives inbound communication from clinicians, patients, and staff via phone, text, email, and/or call center platforms to address scheduling needs, and handle urgent or emergent requests. Assesses caller needs to identify urgent clinical matters for immediate warm transfer to clinic staff. For non-urgent requests (refills, clinical questions), accurately documents and route communications to the appropriate staff via the EMR. Verifies patient demographics and insurance information, ensuring compliance with applicable requirements. Research patient requests within the medical record, provide necessary information, and resolve inquiries effectively while maintaining patient confidentiality. Monitors EMR in-baskets, call center systems, and related technology (as needed) to manage communication workflows effectively. Provides timely and professional service to patients, providers, and facility staff, ensuring positive experiences and adherence to standards. Bilingual in English and Spanish Performs other duties as assigned. Complies with all policies and standards. This is a fully remote opportunity. Qualifications H.S. Diploma or GED required Bachelor's Degree in Healthcare Administration, Business Administration, or a related field preferred 1-3 years of experience in scheduling, operations, or healthcare administration required 1-3 years of experience in physician/provider scheduling, patient appointment scheduling, or call center operations Bilingual in English and Spanish Knowledge, Skills and Abilities Proficiency in scheduling software, EMR systems, and Microsoft Office Suite. Excellent verbal and written communication skills with strong customer service orientation. Delivers prompt, courteous, and knowledgeable support to customers. Strong problem-solving skills and attention to detail. Ability to manage multiple priorities in fast-paced hospital, clinic, or call center environments. Knowledge of healthcare industry standards, patient confidentiality, and compliance protocols. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.

Full Time position with a work schedule of Monday - Friday, 8:30am - 5pm Salary Range: $15-$19 At our Access Point Center, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve. The Hospital Call Center Scheduler will work with our Centralized Scheduling Department to support scheduling for primary care practices. The scheduler is responsible for answering inbound calls and schedule patients for appointments. Additional duties include: * Answer inbound patient scheduling calls based on department service level goals and address their concerns in a satisfactory manner. * Communicate with patients to schedule, re-schedule and/or cancel their primary care provider appointment requests accurately by following practice scheduling protocols and tools. * Accurately collects and performs data entry of all required patient demographic and insurance in-formation. * Uses professional communication etiquette and listening skills to assist patients with their scheduling needs. * Build a safe and trustworthy environment with patients by utilizing both scripted and non-scripted communication methods. * De-escalate situations involving dissatisfied customers, offering patient assistance and support. Escalate any problems that may arise to management. * Utilize and maneuver between several different software systems using dual monitors. * Maintain accurate and up to date information in the documentation system. * Maintain confidentiality of account information and provide exceptional customer service to all clients. * Assist with other projects as assigned by management. Qualifications and requirements The requirements listed below are representative of the knowledge, skills, and/or abilities required. * Education: High School Diploma/GED required. Associate degree or bachelor's degree preferred. * Experience: Two years of related experience in medical setting, or one year of previous healthcare call center or customer service experience, or 3 or more years of call center experience. Basic healthcare knowledge required. * Proficient user knowledge of Windows Office programs (Word, Excel, PowerPoint), and the ability to learn specialized computer applications. * Professional, articulate communication style. Ability to multi-task in several computer applications while holding a conversation with a client. * Excellent attention to detail and data entry accuracy required. Flexibility to quickly adapt to any new business environment. Must be able to work in a remote Team environment. * Must live in the United States. * Preferred Skills: ability to type a minimum of 25 WPM. * Technology requirements: Internet Download speed of 100mbps and Upload speed of 20mbps Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers: * Comprehensive medical, dental, and vision plans, plus flexible-spending and health- savings accounts * Income-protection programs, such as life, accident, critical-injury insurance, short- and long-term disability, and identity theft coverage * Tuition reimbursement, loan assistance, and 401(k) matching * Employee assistance program including mental, physical, and financial wellness * Professional development and growth opportunities Lifepoint Health is an Equal Opportunity Employer. Lifepoint Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.

Department Name: Work Shift: Day Job Category: Clinical Support Estimated Pay Range: $21.01 - $31.51 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Great careers are built at Banner Health. There's more to health care than doctors and nurses. We support all staff members as they find the path that's right for them. Apply today, this could be the perfect opportunity for you. In this role, you will be responsible for completing and submitting Medicaid/Medicare/Commercial Health Plan enrollment applications for healthcare providers and/or facilities. The ideal candidate has prior experience with Medicaid/Medicare or healthcare administrative processes. Excellent communication, attention to detail and organizational skills are essential for this position. This Credentialing Specialist role is remote only for applicants who reside in the following states: Arizona (AZ), California (CA), Colorado (CO), Nebraska (NE), Nevada (NV), and Wyoming (WY). The schedule is Monday - Friday, 8am-4:30pm. POSITION SUMMARY This position performs the department's credentialing work as outlined in the policies and procedures. Obtains all primary source information necessary for all organizational facilities and entities. The incumbent maintains records and the integrity of highly confidential information that is protected from discovery by applicable state statutes. CORE FUNCTIONS 1. Performs the appropriate (applicable) credentialing processes in a timely and complete manner. 2. Performs analysis and appropriate follow-up. Works with many individuals to acquire necessary materials and information, including, but not limited to: physicians, facility staff, professional staff and physicians' office staff. 3. Performs relevant data entry into the database to ensure consistency and integrity of the data. 4. Processes appropriate queries for expired licensure, or any appropriate regulatory credentialing requirement and maintains documentation in the database. 5. The incumbent performs and completes activities within the parameters established by the director and supervisor and as outlined in the facility/entity documents. Manages own duties and functions independently. Work requires the constant exercise of a high degree of independent judgment in response to complex and sensitive credentialing issues, decision making and discretion. Uses independent decision making processes and handles assigned duties in a meaningful and confidential manner with a minimum of supervision. Handles physician inquiries and problems within the scope of job function and keeps supervisors apprised of all issues as they occur. Department and hospital responsibility. Internal customers include facility medical staff services, physicians, hospital personnel, corporate staff, hospital management, and volunteers. External customers include but are not limited to regulatory/accrediting and licensing agencies, legal entities, state and national databases, other hospitals and the general public. MINIMUM QUALIFICATIONS Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of an associate's degree. Must possess a strong knowledge and understanding of healthcare planning as normally demonstrated through three years of credentialing and/or process management and operations experience. Requires a basic knowledge of medical terminology, medical staff organization and extensive knowledge of credentialing procedures. Must have experience in interacting with physicians and allied health professionals, their office credentialing representatives, and hospital personnel. Must have excellent communication skills, both verbal and written, along with astute judgment in areas of human relations. Must demonstrate an ability to meet deadlines in a multi-functional task environment. Requires excellent organizational skills and operational knowledge working with work processing, spreadsheets, data entry, fax machines, and other computer related skills. Must, at all times, maintain efficiency and timeliness in all daily activities. Must be able to establish daily work priorities and work efficiently to contribute to the successful overall maintenance of the credentialing process. Provides optimal customer service to meet the organization's expectations. PREFERRED QUALIFICATIONS National Certified Provider Credentialing Specialist (NCPCS) certification preferred. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy

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

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

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

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

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

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

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

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

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

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

Hospital Medicare Biller (Remote) (Job Number: 549918) Description At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job SummaryThe Patient Account Representative I performs a variety of revenue cycle activities including billing, collections, cash posting, and customer service in support of hospital and physician accounts. This position ensures accurate and timely financial documentation and reimbursement through effective communication with patients, insurance companies, and other stakeholders. The representative maintains compliance with all regulations including HIPAA, and adheres to organizational policies and procedures. Essential FunctionsAccurately and efficiently processes patient accounts, including billing, collections, and payment posting. Responds to and resolves inquiries from patients, insurance carriers, and internal departments. Prepares and submits claims using billing systems; works claim edits and rejections. Follows up on unpaid accounts and performs collections activities as appropriate. Researches and applies unidentified payments. Balances daily cash posting and reconciles discrepancies. Files appeals and reconsideration requests as per department protocol. Identifies and reports overpayments; ensures appropriate refunds. Participates in A/R clean-up projects and other revenue cycle initiatives. Maintains productivity and quality standards while managing daily work queues. Demonstrates ownership and accountability in completing assignments. Knowledge/Skills/Abilities/ExpectationsAbility to communicate effectively, both verbally and in writing. Ability to work independently with minimal supervision. Strong customer service and interpersonal skills. Basic general accounting and bookkeeping knowledge. Knowledge of medical billing practices and medical terminology. Proficient in Microsoft Excel, Word, Outlook, and experience with systems such as Epic and SSI (preferred). Operates 10-key pad efficiently (for cash posting roles). Demonstrates flexibility and teamwork across all business office functions. Qualifications EducationHigh School Diploma or GED EquivalentLicenses/CertificationsRelevant licensure and practices obtained within timeframe required by facility policy Experience1-2 years previous hospital and/or physician business office experience preferred Job: Administrative/Clerical/SecretarialPrimary Location: TN-Brentwood-Corp Personnel Area 8Organization: 0297 - Corp Personnel Area 8Shift: Day