Customer Service Supervisor (Health Insurance)

We are looking for a Supervisor Member Care

The Member Care Supervisor will be responsible for supervising a team of Member Care Specialists (MCSs).  This position will work closely with the Manager/Director for coaching and mentoring the team. This serves as the first point of escalation and the Supervisor is expected to manage the day-to-day workload and client log daily. This role is client facing so the Supervisor must be confident in presenting and discussing customer service updates on weekly meetings. Supervisor will provide the highest-level customer service support to members and providers regarding benefits, eligibility and claims reimbursement via inbound calls, outbound calls, email, and fax. 

Responsibilities Include:

• Supervise the activities of the team and provide direction and guidance on work assignments.
• Ensure that team performance goals and client SLA’s are being met
• Assess individual training needs on an ongoing basis.
• Instruct and inform new team members.
• Handle escalations/customer inquiries/complaints received and ensure that appropriate action is taken, including follow up.
• Stay current on and demonstrate a basic understanding of the business, technologies, content knowledge, processes, procedures and assigned clients.
• Build effective working relationships with peers, team members, managers, and clients/customers.
• Operate as back-up and support for other Sup/TL as needed within the appropriate scope of responsibility.
• Complete daily projects and perform additional duties as requested.
• Comply with and adhere to all regulatory compliance areas, policies, procedures and "best practices”, including HIPAA, Data Privacy laws and company data security requirements.
• Answer overflow inbound calls, outbound calls, email, and faxes.
• Tracking and reporting on volume, metrics, and escalations
• Compile data to present to clients.

Qualifications:

• A minimum of 2 years of prior supervisor/management experience, with at least one year ideally in the healthcare sector.
• Minimum of 1 year of successful customer service experience, in a TPA, in the health, insurance or benefits industry
• Knowledge of CPT codes, ICD-9/ICD-10 coding and medical terminology
• Ability to provide a high-level member and provider support experience.
• Demonstrated ability to communicate professionally, both written and verbal
• Understanding and awareness of the data privacy regulatory rules in one industry (health, insurance, banking, financial services, credit, and collections) and the willingness to learn and adhere to all legal regulations by handling confidential information with sensitivity and discretion in accordance with HIPAA and Data Privacy laws
• Proficiency in Microsoft Office applications and other web-based software applications
• Computer knowledge and ability to learn new proprietary computer systems.

Skills & Interpersonal Behaviors and/or Leadership Skills:

• Strong communication skills to coach and mentor individuals in continuous performance improvements
• Strong written communication skill
• Ability to work independently and make sound business decisions when necessary.
• Critical thinking and probing skills to understand underlying cause and effect
• Flexibility and understanding how to pivot when the business needs change.

What does Success look like?

• An individual with the ability to coach and manage a team of diverse individuals to meet and exceed performance goals and inspire individuals to do more at times in a startup environment. An individual who is looking to make changes that will improve the department and propel the organization forward and has the initiative and sounds business decision making to work independently.

Work Location:

• Buffalo-based office, with some work from home flexibility working the late shift 11:30am - 8:00pm.