SUPERVISOR, CUSTOMER SERVICE (2993)

Job Summary:

The Customer Service Supervisor will serve as serve as a liaison between Customer Service Representatives, management, and other various departments. This individual will be responsible for resolving customer inquiries via telephone and providing written correspondence in a timely and appropriate manner.

Responsibilities:

• Oversee and assess customer service staff activities and provide them with regular performance-related feedback.
• Answers customers’ questions, resolves problems, and maintains customer satisfaction by providing problem-solving resources and supervising day-to-day operations in the customer service department.
• Manages a team of assigned customer service representatives and ensures they comply with company guidelines particularly related to the quality of service.
• Monitors or reviews calls or other correspondence between representatives and customers.
• Ensures that representatives are informed about changes to company products and services.
• Collects data and prepares reports on customer complaints and inquiries.
• Identifies opportunities to update or improve customer service procedures and makes recommendations to the Director of Customer Service or other appropriate staff.
• Training staff in areas of customer service and company policies.
• updates job knowledge by participating in educational opportunities, maintaining personal networks, and participating in professional organizations.
• Investigate and resolve authorization, eligibility discrepancies and claims issues in coordination with health plan and/or internal processes.
• Coordinate the day-to-day work functions, acting as a “go to” person and investigating and resolving complex issues.
• Initiate change requests to resolve system configuration questions impacting authorizations, eligibility and claims processing; review and test results.
• Educate members and/or providers on health plan initiatives; train and assist providers regarding proper authorization submissions, eligibility verifications and claims billing procedures.
• Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters.
• Provide first call resolution and “own the process” by working with appropriate internal/external resources and ensure the closure of all inquiries.
• Document all activities for quality and metrics reporting through the Customer Service module in QuickCap.
• Identify trends related to member and/or provider inquiries to respond proactively and provide feedback to management.
• Collaborate with other departments on cross-functional tasks and projects.
• Maintain performance and quality standards based on established call center metrics including turn-around times. 
• Performs audits to monitor compliance in order to conform to department policies and procedures.
• Interacts with other department personnel to ensure coordinated efforts. 
• Maintains an appropriate, professional demeanor at all times.
• Enhances professional growth and development through in-service meetings and educational programs.
• Performs related duties consistent with the scope and intent of the position.
• Regular attendance.
• Travel as required.

Other Functions

• Enforces Company policies and safety procedures.
• Regularly updates job knowledge by participating in educational opportunities, reading professional publications, maintaining professional networks, and participating in professional organizations.
• Maintain IPA, Health Plan compliance standards.

Competencies

• Three (3) years’ experience in a health care, customer service or a managed care setting required.
• Strong oral and written communication skills, with the ability to communicate professionally with diverse individuals and groups inside and outside of Vivant.
• Excellent active listening and critical thinking skills.
• Ability to demonstrate compassion and sensitivity to patients’ needs and concerns.
• Ability to demonstrate professionalism, confidence, and sincerity in a diverse work culture.
• Ability to consistently deliver excellent customer service.
• Ability to solve mid-level problems with minimal supervision.
• Ability to demonstrate professionalism, confidence, and sincerity while quickly and positively engaging providers.
• Ability to develop and present training materials to an audience.
• Excellent attention to detail, multi-tasking, time management, project management, and organization skills.
• Ability to multi-task, exercise excellent time management, and meet multiple deadlines.
• Demonstrated excellence in project management and organization.
• Ability to provide and receive constructive job and/or industry related feedback.
• Ability to maintain confidentiality and appropriately share information on a need-to-know basis.
• Ability to exercise sound discretion and strict maintenance of confidentiality of all confidential and sensitive communications and information.
• Excellent attention to detail and ability to document information accurately.
• Ability to effectively and positively work in a dynamic, fast-paced team environment and achieve objectives.
• Demonstrate commitment to the organization’s mission.
• Must have mid-level skills in Microsoft software (Word, Excel, PowerPoint).
• Must have the ability to quickly learn and use new software tools.
• Must have mid-level skills using e-mail applications.
• Self-motivated with strong organizational, multi-tasking, planning, and follow up skills.
• Ability to work independently as well as in a team environment.
• Ability to present self in a professional manner and represent the Company image.
• Demonstrated leadership and project success are expected.

Education and Licensure

• High School Diploma or GED minimum requirement.
• BA/BS in related field preferred.

Travel

• The incumbent may travel up to 5% of the time.

Supervisor Responsibility

• This position supervises several employees in multiple disciplines: Customer Service Representatives. Up to 15 non-exempt employees.

Work Environment

This job operates in a professional office environment.  This role routinely uses office equipment such as computers, phones, photocopiers, scanners and filing cabinets.

Salary : $75,000 - $85,000