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Quality Assurance Team Lead

3 months ago

Plano, United States ManhattanLife Insurance & Annuity Company Full time
Job DescriptionJob Description

Who we are:

ManhattanLife Insurance and Annuity Company was founded in 1850, the Company’s longevity makes it one of the oldest and most reliable health and life insurance companies in the country. Operating successfully for 174 years is a testimony to ManhattanLife’s enduring history, and an indicator of the reliability of our future. ManhattanLife’s headquarters are in Houston, TX and the company is continually growing with multiple office locations nation-wide. ManhattanLife offers attractive employee benefits starting day one, including immediate coverage under our health, dental and vision plans. We offer flexible schedules, including shortened hours on Fridays, free parking, company-wide events, professional development (LOMA testing) and a company-wide wellness program.

Scope and Purpose:

We are seeking a Quality Assurance Team Lead for our Customer Service department at our Plano, TX office. Plano, TX office. In the role of Quality Assurance Team Lead, you will be responsible for delivering exceptional service to our clients, plan participants, brokers, and vendors. You will serve as the primary point of contact, providing assistance with inquiries, claims, and benefit administration. Your role is crucial in ensuring client satisfaction and maintaining the high standards of service expected from our organization.

Duties and Responsibilities:

  • Review quality of work preformed by vendor through live monitoring and use of call recording system and applications.
  • Uses quality monitoring data management system to compile and track performance at team and individual levels.
  • Act as the frontline support for clients, responding promptly to inquiries via phone, email, or chat and providing accurate and helpful information regarding their benefit plans, coverage, and options.
  • Handle processing of data entry, verification of eligibility, documentation review and ensuring compliance with regulatory requirements and company policies.
  • Educate clients and plan participants on their benefit plans, explaining coverage details, claim status, and applicable co-pays, deductibles, or limitations in a clear and understandable manner.
  • Investigate and resolve customer complaints, disputes, or issues related to claims denial, coverage discrepancies, billing inquiries or plan administration errors, escalating complex cases to supervisors or management as needed.
  • Maintain accurate and detailed records of customer interactions, claims transactions and correspondence using our Claims/CRM system, ensuring confidentiality and compliance with data protection regulations.
  • Coordinate with internal departments such as claims processing, billing/enrollment, and account management to address customer needs efficiently, facilitating timely resolution of issues and ensure seamless service delivery.
  • Proactively identify opportunities to improve processes, enhance service quality, and streamline operations to optimize the customer experience and increase overall satisfaction.
  • Participate in training and team meetings as needed.

Minimum Qualifications:

High School Graduate or equivalent (GED).

Knowledge, Skills and Abilities:

  • At least 3-4 years of customer service experience, preferably with experience in healthcare, benefits administration or the TPA Industry.
  • Excellent verbal and written communication skills, with the ability to convey complex information clearly, professionally, and empathetically to diverse audiences.
  • Strong interpersonal skills with a customer-centric approach, patience, and empathy to build rapport, manage difficult situations and resolve conflicts effectively.
  • Detail-oriented with the ability to multitask, prioritize tasks, and manage time effectively in a fast-paced environment while maintaining accuracy and attention to detail.
  • Proficient in using computer software and navigating online systems; experience with Claims management platforms, CRM software and Microsoft Office Suite.
  • Possess a strong understanding of insurance regulations, HIPAA compliance, and confidentiality requirements related to handling sensitive customer information.

Travel Requirements:

This position may require light travel as needed.

Professional Development:
  • Establish annual objectives for professional growth.
  • Keep pace with developments in the discipline.
  • Learn and apply technologies that support professional and personal growth.
  • Participate in the evaluation process.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle or feel objects, type, and use mouse; reach with hands and arms and talk and/or hear. The employee is required to sit for extended periods of time. The position may require lifting, pulling or moving items weighing upwards of 10 pounds as it relates to office or desk supplies.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee regularly works in an office environment. This role routinely uses standard office equipment such as computers, phones via WebEx, physical phone while in office, and photocopiers when necessary.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to the job at any time without notice.

AAP/EEO Statement:

ManhattanLife prohibits discrimination based on race, religion, gender, national origin, age, disability, veteran status, marital status, pregnancy, gender expression or identity, sexual orientation, or any other legally protected status. EOE Employer/Vet/Disabled. ManhattanLife values differences. We are committed to fostering an environment that attracts and retains a diverse workforce. With individuals from a variety of backgrounds, ManhattanLife will be better equipped to service our customers, increase innovation, and reduce risks. We encourage the unique perspectives of individuals and are dedicated to creating a respectful and inclusive work environment.