Member Services Eligibility Rep.

Excellent employment opportunity!


ABOUT US:

Molina Healthcare of California, an affiliate of Molina Healthcare, Inc., is among the fastest growing healthcare companies in California—serving members in Northern and Southern California through its network of primary care clinics, physicians and hospitals.

Molina’s delivery system provides for a comprehensive approach to good health. In California, Molina operates primary care clinics with physicians employed by the company and subcontracts with IPAs, medical groups and individual physicians.

Molina prides itself on its ability to combine the best attributes of private practice with an emphasis on preventive care. Patient-centered medicine is the Molina philosophy. Other reasons for Molina’s success has been its adherence to uniform practice guidelines, a strong commitment to case management principles; and above all—an unwavering respect for the patient.


Member Service Eligibility Representative, Member Services


Job Description:

To assist the Member Account Reps in daily operations as well as Molina’s staff corporate, providers and members in obtaining proper PCP information. Ensuring that all Member Moves are processed and that notifications are mailed timely.

Completing Auto-Assignment processing including QA reporting. Ensure all members are assigned to the correct Practitioner. Process and create eligibility lists and exports (includes electronic, hard copy-paper and diskettes exports). Validate membership enrollment for ID Card vendor processing.

Defines, monitors and reports to management performance and productivity standards specific to those systems that must be in place to serve Molina’s provider network and its enrolled population. Including queue awareness when Supervisor is unavailable.

Oversees the daily processing of all PCP transfers and requests of retro-capitation submitted to Finance Department monthly.
Assist with training of new Member Service Account Reps and provide ongoing training to staff as needed.

Participate as a team player by demonstrating support to peers, management and the department’s goals. Attend meetings and training sessions as scheduled. Show flexibility in meeting changing performance objectives consistent with Molina and department objectives.




Excellent benefits and compensation package, as well as growth opportunities.


To be considered for this position please send your resume with salary requirements by E-Mail to