Under the supervision of the Member Service Manager, this position is responsible for the delivery of superior customer service by ensuring calls are answered effectively and efficiently throughout the day. The primary functions of this role are supervising overall call traffic, processing incoming calls, resolving escalated calls, dispatching supervisory calls, assisting Member Services Representatives with any client related questions and ensuring the Reps' adherence to schedules, policies and procedures. This position will assist in training new Member Services Representatives on job-specific roles and responsibilities.
- Assists in training new Member Services Representatives on job specific roles and responsibilities
- Handles escalated calls.
- Serves as floor and general supervisor; directing phone flow and taking representative questions to help with call management.
- Delegates work to Representatives as needed.
- Monitors Representatives for quality and training purposes.
- Conducts Call Quality Audits
- Handles system emergencies with direction from IT department and/or appropriate vendor.
- Assists with Representative task assignments in the Manager's absence.
- Assists in disseminating information to staff as needed.
- Monitors call traffic and makes adjustments based on call center traffic patterns.
- Performs other related duties and special projects as requested.
- All other duties assigned by management
- Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals.
- Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)
- Analytic ability to organize and prioritize work to meet deadlines
- Strong computer application skills including Microsoft Word, Excel and Visio
- Excellent written and verbal skills required
- Good judgment, initiative and problem solving abilities
- Ability to handle and resolve complex issues with little assistance
- Ability to perform multiple tasks simultaneously
- Ability to communicate effectively
- Proficient telephone, customer service, communication and documentation skills required.
- Must have the ability to work a flexible work schedule (including evenings and weekends).
- Bilingual (Spanish) a plus.
- Three years healthcare experience with Managed Care experience preferred
- Two years prior call center experience preferred.
- Experience in Avaya CMS Supervisor is highly preferred.
- Prior experience working with TRICARE, Texas Medicaid, Medicare Advantage highly desirable.
C. Licenses, Registrations, or Certifications: