Health Insurance Customer Service Manager

2 weeks ago

Miami, United States PayerFusion Holdings LLC Full time
Job DescriptionJob DescriptionJOB DESCRIPTIONAbout Us

We are a service-based company and a licensed Third Party Administrator creating a full-featured software suite for the healthcare industry from scratch. We’re an innovative company creating a unique experience for healthcare professionals. While many industry-wide solutions exist, nothing comes close to our ground-breaking approach.

PayerFusion's innovative services utilize the latest medical claim processing technology coupled with our unique healthcare cost containment methodologies to provide you with the sharpest advantage possible.

We are seeking only top talent and experienced personnel in order to meet and exceed our client's expectations.


About the Position

The Customer Service Supervisor is responsible for the day-to-day activities of the Customer Service Department. The position will supervise employees, identify training needs and provide new employee and refresher training for staff. The position will handle escalated service issues from staff, other departments, and clients and is a primary support to the General Manager for service resolution. The Customer Service Supervisor will additionally be hands on, taking live calls as volume mandates. The Supervisor will also be responsible to monitor incoming calls and make sure that we have the right amount of staff to service our clients at all times.

  • Implement client service level agreements
  • Thoroughly research and appropriately respond to all verbal and written requests for assistance from clients, providers of service, and any other request as needed.
  • Identify problems/trends and assist the General Manager in creating and documenting resolutions. Recommend procedures and controls for problem prevention. Provide input for changes and process improvements.
  • Prioritize workload and monitor coordinator’s productivity.
  • Work closely with Claims and Case Management Department to resolve complex, escalated issues.
  • Train staff on departmental tasks, procedures and processes as needed. Train new staff and continuously monitor work during probationary period.
  • Assist with departmental metric reporting.
  • Develop and maintain departmental procedures.
  • Monitor time-off requests and timecards for payroll purposes. Work directly with the General Manager to maintain the highest level of phone resources at all times.
  • Assist the General Manager with the completion of employee performance reviews.
  • Ensure compliance with HIPAA and other regulatory and legal guidelines, and troubleshoot and resolve customer/client service issues.
  • Perform Quality Assurance call reviews.
  • Take live calls when call volume mandates.
  • Fulfills departmental requirements in terms of providing work coverage and administrative notification during periods of personnel illness, vacation or education.
  • Create seamless operations between departments
  • Report accomplishments as well as inefficiencies to manager
  • Perform other similar and related duties as required.
Job Requirements
  • Associate’s degree in a related field, or equivalent combination of education and work experience.
  • A minimum of 3 year experience in a Supervisor or Lead role involving health insurance benefits. Call center experience is preferred.
  • Experience in management of a small call center.
  • Experience in Benefits Administration (claims processing, auditing, and/or configuration/programming) preferred.
  • Ability to read & interpret Medical and Dental benefit plans.
  • Excellent analytical and problem resolution skills and ability to maintain high attention to detail are required.
  • Must have excellent verbal and written communication and interpersonal skills to interface with all levels of the organization and clients.
  • Strong decision-making and organizational skills, with the ability to optimize the use of all available resources and deliver on multiple priorities.
  • Exceptional team player with the confidence and integrity to earn client and internal team confidence quickly.
  • Proficient PC skills including intermediate to advanced Microsoft Word, Excel and Outlook skills. PowerPoint experience preferred.
  • Knowledge of ICD and CPT coding a plus.
  • Ability to work varying shifts

Perks:

We provide a great culture, competitive salary, excellent benefits (Health, Dental, Vision, Life Insurance, Vacations, 401K) and a fast-paced environment which nurtures innovation and collaboration.

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