Supervise and provide guidance to Customer Service Representatives regarding department policies, procedures, and workflow. Responsible for hiring, mentoring, coaching and evaluating team members’ performance. Demonstrate effective leadership to improve individual performance and develop teamwork and team support. Manage change and encourage collaborative relationships, involvement and initiative.
Provide supervision, coaching, training, support, evaluation and leadership to assigned staff.
Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
Monitor, evaluate and report service performance for the department and determine staffing needs related to day-to-day performance goals.
Investigate and settle issues not resolvable by customer service representatives. Relay information for dispute resolution to appropriate departments and personnel.
Assist with answering inquiries received by phone, mail, e-mail or in person, providing exceptional service.
Assist in appeal research and resolution.
Coordinate business activities by maintaining collaborative partnerships with key departments.
Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
Actively participate as a key team member in department meetings.
Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
Serve as back-up to the Customer Service Manager as needed.
Maintain department visual board.
Meet department and company performance and attendance expectations.
Perform other duties as assigned.
Work Experience: Two years medical insurance or other healthcare related field preferred. Prior customer service/call center experience preferred. Claims processing preferred. Experience in leadership preferred.
Education, Certificates, Licenses: High School Diploma or equivalent
Knowledge: Computer Skills, Typing and 10-key required. Medical terminology, CPT & ICD-9 coding preferred, Microsoft word/excel preferred.
- Building Trust
- Building a Successful Team
- Aligning Performance for Success
- Building Strategic Work Relationships
- Continuous Improvement
- Facilitating Change
- Leveraging Diversity
- Driving for Results
- Building Customer Loyalty
- Decision Making
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to foster individual, team and company growth.
- We actively participate in efforts to improve our many communities-internally and externally.
- We encourage creativity, innovation, and the pursuit of excellence.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity and affirmative action employer.
PacificSource Health Plans is anything but a typical health plan. We’re a growing, independent, not-for-profit organization with a...