Member Services Rep - Vietnamese

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 Services Representative - Vietnamese, Member Services


Job Description:

To serve as a liaison between Molina and its members. Ensures that all members receive a level of service that exceeds their expectations. Using three methods of communication (inbound and outbound calls, written correspondence, and face-to-face. Respond and resolve questions and problems from current/prospective members, or their representatives, providers, and other appropriate parties.

Be proficient in discussion and execution including, but not limited to the following:

Benefit clarification/eligibility verification/claim status.

Medical group/PCP, dental and vision provider assignments.

Explanation of how the plan works and how to utilize the services.

Assist with information regarding referral or authorization.

Change of provider/member information.

Any complaints/grievances.

Identification card requests.

Update new member eligibility on appropriate systems.

Perform overrides for covered/authorized prescriptions as needed.

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

Document all member inquires and complaints in appropriate systems and either handle, redirect, or defer to the appropriate department for resolution.


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


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