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Auditor, Support Center Quality - Remote (Bilingual Spanish)

Role overview

Qualifications

  • At least 2 years of progressive work experience in quality assurance/auditing, call center, and/or customer service experience
  • Understanding of insurance products including Medicaid, Medicare and Marketplace/enrollment processes
  • Customer service skills, including ability to conduct thorough research
  • Attention to detail, organizational and time-management skills

Responsibilities

  • Facilitates call monitoring and assessment of call center representatives
  • Participates in call calibration exercises and internal listening sessions
  • Assists quality leadership in providing standard weekly and monthly reporting
  • Ensures internal and external customer interactions are handled in compliance with established procedures

Key facts

  • Remote from: United States
  • Full time
  • Mid-level (2-5 years)
  • Auditor
  • English

Hard skills

Other skills

  • Quality Assurance
  • Customer Service
  • Detail Oriented
  • Organizational Skills
  • Time Management
  • Client Confidentiality
  • Microsoft Office
  • Social Skills

About the company

Molina Healthcare logo

Molina Healthcare

Health Insurance (Payers)

Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

  • JOB DESCRIPTION Job Summary

Provides support for call center quality and excellence through auditing activities including:  monitoring and assessing customer interactions of support center representatives, documenting performance strengths and weaknesses, identifying immediate compliance issues, assisting in generating standard process measurement reporting, and developing quality guidelines and procedural manuals.

Essential Job Duties

• Facilitates call monitoring and assessment of call center representatives for both inbound and outbound calls for the member and provider support center.
• Participates in call calibration exercises and internal listening sessions.
• Assists quality leadership in providing standard weekly and monthly reporting within predetermined reporting parameters. 
• Provides regular feedback to quality leadership regarding call trends or compliance issues that arise.
• Collaborates with quality leadership to continually define quality assurance guidelines.
• Ensures internal and external customer interactions are handled in compliance with established procedures and standards. 
• Demonstrates subject matter expertise in all business segments that require auditing (Medicaid, Medicare, Marketplace). 
• Offers suggestions for process improvement and exceptional customer experience.
• Assists with the creation and updating of support center procedure/training manuals.
• Maintains overall objectivity in supporting consistent and superior customer service.

Experience coaching and developing employees, including providing 1:1 performance feedback related to quality, customer experience, and performance improvement. Previous coaching experience in a Quality, Lead, Trainer, or Supervisory capacity is preferred.

Provides inbound phone support as needed based on business and operational needs. Team members may be required to assist with call handling on designated days or during periods of increased call volume.
 

Required Qualifications

• At least 2 years of progressive work experience in quality assurance/auditing, call center, and/or customer service experience in a fast-paced/high-volume environment, or equivalent combination of relevant education and experience.
• Understanding of insurance products including Medicaid, Medicare and Marketplace/enrollment processes.
• Customer service skills, including ability to conduct thorough research while maintaining coherent conversation with customers. 
• Data processing experience.
• Attention to detail, organizational and time-management skills, and ability to manage simultaneous tasks to meet business needs.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Effective verbal and written communication skills.  
• Proficiency in Microsoft Office suite and applicable software programs.
 

Preferred Qualifications

• Progressive auditing work experience in call center quality assurance.
• Managed care 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

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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