Manages the Customer Service Department in order to deliver service excellence to providers, and internal and external customers, including business partner stakeholders. Provides guidance and leadership for staff to ensure employees are achieving customer satisfaction through effective communication, problem solving, professional phone etiquette and efficient processes. Develops and manages the Customer Service department budget. Analyzes human resource needs, recruitment and selection of personnel, training and education. Develops and implements improved processes, policies, and programs. Supports projects which affect the Customer Service Department and Operations. Participates in developing and analyzing projects and initiatives which impact the organization, business partners and vendors. Produces statistics and metrics and plans for growth and expansion.
Advanced MS Office. Management experience of exempt and non-exempt employees. Customer service experience. Critical and analytical thinking and problem-solving skills. Ability to work in a fast paced, changing environment. Excellent interpersonal and communication skills, including the ability to address a wide range of audiences. Experience in working with business partners and and vendors. Experience with planning and implementing projects and process improvements.
- Manages the Customer Service Department. Plans, analyzes, organizes, prioritizes and communicates work requirements to staff. Motivates and develops employees to achieve department and organizational goals.
- Leads and participates in project and business initiative planning and implementation with multiple departments, business partners and vendors.
- Develops customer service tools and training for staff. Analyzes human resource needs and establishes employee goals. Delivers performance reviews and development plans. Conducts interviews and selects employees.
- Develops, implements, reviews and revises processes, policies, and programs.
- Assists staff in solving escalated provider or member issues through coaching on problem-solving techniques. Works closely with multiple departments and senior leadership and business partners on group implementation plans, legal inquiries, appeals, and special requests.
- Develops and manages the Customer Service Department budget including monthly financial activity based costing (ABC) reporting, and other reporting requests based on business partner expectations. Other duties as assigned.
- Bachelor's Degree or commensurate experience
- 5 to 7 years in insurance industry or a related field. 1 - 2 years operations and supervisory experience in a call center environment.
- Six Sigma certified or CQI experience
- Experience in continuous improvement and project management methodology.