[Hiring] Auditor @Molina Healthcare

Role Description

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
• 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.
• Provides inbound phone support as needed based on business and operational needs.

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.

Benefits

Molina Healthcare offers a competitive benefits and compensation package.

Company Description

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.