Provides support /service to meet the needs of our Molina providers. Provides service information, & identifies opportunities to improve our provider experiences. Responsible for continuous quality improvements regarding provider engagement & retention. Represents Provider issues in areas involving impact & engagement including: Appeals & GrievancesKNOWLEDGE/SKILLS/ABILITIESThis role supports providers on issues of varying complexity along with working to improve provider retentionResponds to inbound/outbound call in order to support & retain providersProvides excellent customer service Accurately documents all calls and interactions through alternate channels.Demonstrated ability to quickly build rapport & respond in a professional manner by identifying & exceeding expectations.Engages & collaborates with other departments.Supports provider for a wide variety of inquiries & assistance involving their benefits, claims, premiums, & other issues. Conducts initial research & works to immediate resolve issues.Appropriately escalates issues based on established risk criteria.Proficient in at least two lines of business (for example: Medicare, Medicaid, Marketplace & MMP) & Provider Services.Accurately documents all calls and interactions through alternate channels.Proactively engages & collaborates with other departments as required.Assists with training needs of other employees or training classes as needed.Supports provider needs for a wide variety of inquiries involving member eligibility, & covered benefits.Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing & other provider related issues.Conducts initial research & work to immediately resolve issues.Communicates timely & professionallyKnowledgeable in systems utilized:SalesforcePegaQNXTCRMVerintKronosMicrosoft TeamsVideo ConferencingCVS CaremarkAvailityMolina Provider PortalOthers as required by line of business or state

Demonstrates & abides by the Commitment to Care behavior standards.• Welcomes, guides/ directs visitors & other customers.• Checks in patients in an accurate, efficient, timely manner & professional manner• Captures or completes the registration process in an accurate, efficient & timely manner• Identifies & accurately collects co-pays or appropriate fees/payment• Verifying Insurances insurance through Healthila & manually updating patient accounts• Provides patient balance & collects payments• Communicate wait times in a diplomatic manner as appropriate• Directs patients to the appropriate care area• Provide patients w/ appropriate forms, questionnaires, etc• Schedules appointments or procedures in clinic• Resolves non-clinical patient issues, provides backup & coverage as needed.• Prioritizes between these functions on an ongoing basis to maximize efficiencies of clinic schedules & reduce patient waiting times.• Complete financial reconciliation processes• Complete appointment preparation• Arranges any accommodation or interpreter services needed for the patient visit.• Answers telephone & responds appropriately to the caller• Takes & relays messages requiring follow-up to appropriate individuals• Prepares records and materials for new patient appointments• Maintains knowledge of appointment scheduling practices, policies & procedures• Schedules appointments in an accurate and timely manner• Assists with clerical duties of the clinic, e.g., faxing information, making copies, etc.• Cancel & reschedule appt management• Waitlist management• payment processing/reconciliation• Front desk resource/liaison for patients, providers, staff• Prior authorization• Complex specialty scheduling• DAR Updates for the next business dayIncluding but not limited to:• Closing clinic• Downtime Process Management• Scanning/ indexing• Management of assistance programs (e.g SAGE)Provider template/schedule management via epic software

Provide positive and courteous customer service at both the reception desk, scheduling services, and over the phone for 12 hospitals and 90+ clinics while maintaining a professional presence at all times.Perform switch board operator/messaging dutiesProvide high quality customer servicePerform reception desk dutiesSecure payments for servicesPerform scheduling and registration dutiesTraining New EmployeesPerform other duties as assigned including but not limited to maintaining neat and orderly work and patient areas, maintaining updated information in patient areas, providing patient assistance, assisting with patient navigation throughout the facility, communicating with providers, testing that system downtime is working properly, performing opening and closing procedures, managing waitlist, reviewing appointments to ensure they are scheduled correctly, serving as a liaison between patient and medical support staff and perform appointment and scheduling duties (e.g. rescheduling appointments, appointment reminders, fixing scheduling errors, etc.) *System includes but not limited to Epic/Excellian, Infinity Telephone Agent software, Microsoft US Bank payment Navigator, Posim, Spabiz, Availity, Healthia*

Pension and Health Care*Use a consultative approach to listen, assess, and resolve the retirees needs and questions with carriers, clients, and third party administrators*Effectively, and empathetically communicate over the phone*Use problem solving skills to identify root causes and issues of inquiries, and provide feedback on resolutionsRepresent the company effectively, while using patience, knowledge, and kindness to deescalate concerned callers*Work as a team player in a diverse, professional call center environment*Adhere to all legal regulations

Received orders and unloaded packages from the truck and stored them properly in the warehouse•Working indirectly as product replenishment and ship dock loader •Packaging merchandise for shipment when an order is placed•Establish and maintain effective warehouse kepping

Responsible for Check cashing and Money Gram wire transfers•Hands on experience in balancing cash drawer and receipts•Performs cashier services; handling large amounts of money daily, operating an automated cash register and processed refunds

Created and constructed original fashion designs and patterns in accordance to customers’ requests•Provided specialized consultative services for new cliental•Repair and maintained industrial grade sewing and textile equipment.•Prepared fashion illustration for design team•Seamlessly planned and executed events, both professional (photo shoots) and social (weddings & birthday celebrations)•Developed effective social networking, and print ad campaigns to promote annual sales events

Conceptualized clothing, shoes, and accessories for customers as well as private clients •Prepared visuals based on new season lines and collections•Increased sales goal by 20% •Managed and implement end of season sales

Answered, screened and directed inbound phone calls •Received and sorted email and electronic deliveries•Performed general secretarial duties, including – meeting scheduling, appointment set up, faxing and mailing•Received and assisted clients and escorted them to correct destinations; offices, rooms or meeting rooms•Handled general requests for information and data from staff and clients