Customer Service Supervisor (Healthcare) - Remote

The Supervisor will be responsible for supervising a team of Member Care Specialists (MCSs). This position will work closely with the Manager/Director for coaching and mentoring the team. This serves as the first point of escalation and the Supervisor is expected to manage the day-to-day workload and client log daily. This role is client facing so the Supervisor must be confident in presenting and discussing customer service updates on weekly meetings. Supervisor will provide the highest-level customer service support to members and providers regarding benefits, eligibility and claims reimbursement via inbound calls, outbound calls, email, and fax.

Responsibilities Include

• Supervise the activities of the team and provide direction and guidance on work assignments.
• Ensure that team performance goals and client SLA’s are being met
• Assess individual training needs on an ongoing basis.
• Instruct and inform new team members.
• Handle escalations/customer inquiries/complaints received and ensure appropriate action is taken, including follow-up.
• Stay current and demonstrate a basic understanding of the business, technologies, content knowledge, processes, procedures, and assigned clients.
• Build effective working relationships with peers, team members, managers, and clients/customers.
• Operate as back-up and support for other Sup/TL as needed within the appropriate scope of responsibility.
• Complete daily projects and perform additional duties as requested.
• Comply with and adhere to all regulatory compliance areas, policies, procedures, and "best practices”, including HIPAA, Data Privacy laws, and company data security requirements.
• Answer overflow inbound calls, outbound calls, email, and faxes.
• Tracking and reporting on volume, metrics, and escalations
• Compile data to present to clients.
  
  

Qualifications

• A minimum of 3 years of prior healthcare supervisor/management experience, with at least one year ideally in the healthcare sector.
• Minimum of 2 years of successful customer service experience in a TPA, in the health, insurance, or benefits industry.
• Experience in HealthEdge or Javelina preferred
• Knowledge of CPT codes, ICD-9/ICD-10 coding, and medical terminology
• Ability to provide a high-level member and provider support experience.
• Demonstrated ability to communicate professionally, both written and verbal
• Understanding and awareness of the data privacy regulatory rules in one industry (health, insurance, banking, financial services, credit, and collections) and the willingness to learn and adhere to all legal regulations by handling confidential information with sensitivity and discretion in accordance with HIPAA and Data Privacy laws.
• Proficiency in Microsoft Office applications and other web-based software applications
• Computer knowledge and the ability to learn new proprietary computer systems.
  
  

Skills & Interpersonal Behaviors And/or Leadership Skills

• Strategic Thinking - Knack for sorting through clutter to find the best route, often by pulling up from the current complexity to identify patterns that guide future direction and allow one to narrow the options and articulate the options from which others can work backward.
• Flexibility/Working through Ambiguity - Tendency to be energized by new experiences/perspectives that test assumptions and thinking. Considers different points of view, sometimes with fragmented information, to arrive at practical, effective, actionable next steps.
  
  

What does Success look like?

• An individual with the ability to coach and manage a team of diverse individuals to meet and exceed performance goals and inspire individuals to do more at times in a startup environment. An individual who is looking to make changes that will improve the department and propel the organization forward and has the initiative and sounds business decision-making to work independently.