Supervisor, Customer Service

Brighton Health Plan Solutions is a healthcare enablement company that provides third-party administration services, provider networks, and technology solutions to improve the health plan experience. The Customer Service Supervisor manages daily member and provider service call center operations, including staffing, performance metrics, quality monitoring, coaching, escalations, and customer satisfaction initiatives.

Responsibilities:

• The Customer Service Supervisor will handle inbound calls from physicians, hospitals and other medical provider representatives
• Supports and mentors the Team Leaders and SMEs as needed. Handles caller escalations and resolves as needed
• Continually monitors the teams call center metrics, quality assurance scores and productivity reports
• Assist the Customer Service Manager with performance reports, QA review sessions and re-training initiatives
• Manages departmental call activity and ensures appropriate staffing levels and scheduling to meet department KPI’s (Key Performance Indicators)
• Answers and handle call center calls when needed to ensure meeting KPI levels
• Conducts quality call monitoring review sessions with the Customer Service Manager to coach performance and identifies additional training needs
• Provides support to customer service representatives as needed
• Manages special projects and allocates resources as needed
• Collaborate with Network management team, Account Managers and Sales teams to gather feedback to enhance service performance
• Conducts impact analysis of any changes to service team operations to ensure internal customers are consulted and informed of pending operational changes prior to implementation
• Participate in activities designed to improve customer satisfaction and business performance
• Works with Customer Service Manager and Director to identify call reduction efforts and executes strategies accordingly
• Support projects and other departments in completing tasks when directed by management

Requirements:

• HS diploma or GED is required
• Experience in a high volume call center
• Experience with claims inquiry and claims review procedures
• Knowledge of medical specialties, fee schedules, complaints and appeals and call center responsibilities
• Previous experience in a physician's office, group practice, clinic or hospital based practices
• General knowledge of medical terminology, medical specialties and HIPAA Confidentiality laws
• Prior experience managing teams in a customer call center
• Experience managing call center volume through use of ACD systems
• Previous experience in quality call monitoring and performance coaching, counseling and progressive discipline
• Proficiency in healthcare transactions systems, CRMs, quality call tools and monitoring systems
• Ability to create staffing schedules and analyze call center volume, trends
• Knowledge of basic computer operations
• Intermediate knowledge of Microsoft Office including Word, Excel, Access, Powerpoint and Outlook
• Strong time management skills
• Knowledge of CPT codes, ICD-9
• Ability to learn quickly
• Knowledge of managed care procedures, claims payment policies
• Courteous with strong customer service orientation
• Bachelor's degree preferred, but not required
• Previous multi-channel experience (i.e. voice, email, and chat) a plus