• Assist customers through phone and live chat. • Answer product and account-related questions. • Guide customers through our platform. • Learn our software and become proficient in using it. • Resolve customer concerns or escalate when appropriate. • Deliver a warm, professional customer experience on every interaction.

• Independently review medical records, bills, and supporting documentation to ensure demand-ready accuracy • Verify billing and treatment timelines (dates, providers, gaps) and flag documentation issues before package assembly • Build and organize complete demand packages with properly labeled supporting exhibits • Identify missing records, bills, liens, or key documents and clearly communicate what’s needed to close the file • Navigate disorganized or incomplete case files to locate relevant documents quickly and confidently • Maintain consistent exhibit preparation and documentation standards suitable for attorney review • Support demand submission workflows using demand preparation software (EvenUp or similar) • Manage multiple active demands at once while meeting volume and deadline expectations • Track and update demand tasks and statuses inside the case management system to keep workflows moving • Contribute to process improvements that reduce rework and increase quality at scale

Role Description Molina Healthcare is hiring a Pharmacy Customer Service Representative. This role is remote for those who live in Florida only. Bilingual - Spanish speaking is needed. Our agents assist with all Medicaid member Pharmacy-related calls. You will assist the members with obtaining their medications. This is a pharmacy call center environment focused on first call resolution and the member's experience. Pharmacy Reps will be taking calls for the state of FL. Must be bilingual, and live in the state of FL. Shift times will be Monday through Friday 8:00a - 4:30p or 10:30a-7:00p EST, all dependent on business needs. Essential Job Duties - Provides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. - Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. - Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, NCQA guidelines, and CMS standards. - Provides coordination and processing of pharmacy prior authorization requests and/or appeals. - Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. - Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. - Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. - Assists members and providers with initiating verbal and written coverage determinations and appeals. - Records calls accurately within the pharmacy call tracking system. - Maintains established pharmacy call quality and quantity standards. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews (CMRs) through pre-work up to case preparation. - Proactively identifies ways to improve pharmacy call center member relations. Qualifications - At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Requirements - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Health care industry experience. Benefits - Molina Healthcare offers competitive benefits and compensation package. - Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

• Help Our Partners: Take calls, provide initial advice and provide regular updates on ongoing cases to our B2B partners in Italian and English. • Be Transparent & Customer-Centric: Ensure clear, honest communication that reflects our commitment to outstanding partner satisfaction. • Handle Tickets & Escalations: Manage incoming tickets, follow up on escalations, and proactively work on resolution and prevention. • Manage Bookings: Handle booking modifications and relocations with attention to detail and urgency. • Team Collaboration: Actively support and coordinate with other departments to ensure smooth workflows and excellent service delivery. • Manage Expectations: Balance the needs and expectations of both partners and account managers to deliver satisfying outcomes. • Record Details: Accurately document all work and partner interactions in our CRM system.