Call Center Supervisor
The Claims Call Center Supervisor assists the claims manager to supervise the Claims Provider Services Representatives responsible for responding to telephone inquiries from providers as they relate to eligibility, claims status, HPSM’s billing requirements and policies and other general claims related questions. This role will address daily staffing needs, develop, support and provide training to team members, trend and assess both call volume and call reasons to identify opportunities for improvement and communicate these opportunities to internal staff to improve overall department performance and quality.
The essential duties and responsibilities will include the following:
•Manage HPSM’s Claims Call Center to ensure effective and high quality customer service and compliance with internal policies and procedures.
•Monitor performance and productivity against department standards.
•Monitor and evaluate data from the call tracking and call management telephone system for accuracy, completeness, inquiry response time and performance issues
•Identify training needs for the Claim Provider Services Representatives in developing specific training programs for the Service Center
•Accomplish staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and implementing corrective action steps when necessary; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards. Complete performance evaluations in a timely manner.
•Continuously monitor and evaluate unit performance and take steps to improve the efficiency and quality of unit operations.
•Create and update unit procedures, workflows, and resource material.
•Develop and manage auditing and quality control processes.
•Serve as a backup when the call volume warrants it.
•Take ownership of escalated provider calls.
•Monitor incoming call volume and reasons to identify opportunities for overall department improvement
•Support the Claims Manager during absence with Supervising the Claims Recovery Specialist.
•Facilitate and document meetings.
•Maintain knowledge of industry trends, best practices, and regulatory requirements.
•Perform other duties as assigned.
Education and Experience: Two years’ experience in a call center in a supervisory or team lead role.
Thee (3) years of claims processing, adjustment or resolution or other claims payment related field.
Bachelor’s degree in a related field preferred.
Knowledge of: Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint. Managed care processes and procedures. Medi-Cal and Medicare programs. Call center systems, processes and procedures. Claims billing and payment cycle. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.
Ability to: Work cooperatively with others. Work as part of a team and support team decisions. Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks.
Provide excellent customer service. Work to effectively in a fast-paced environment. Coach and develop employees.
Starting Compensation Range: – Depending on Experience
Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s coverage in the medical HMO plan and majority of PPO medical cost. Employee pays a small portion (5%) of the dependent premiums for medical and dental benefits. Additional HPSM benefits include fully paid vision, life, AD&D, and LTD insurance; retirement plan (10% of salary for compensation/HPSM paid); holiday and vacation pay; tuition reimbursement plan; and more.
Submissions without a Cover Letter and Salary Expectations may not be considered.Position Description »