Flexible Insurance Call Center Jobs in Raleigh, NC

About The Role
BHPS is seeking an experienced Customer Service Supervisor to manage the company’s service operations for members and providers and high traffic call center. The Supervisor directly manages the daily performance an activities of the Customer and/or Provider Service call center representatives to ensure customer satisfaction and achievement of the department’s KPI’s. The Supervisor continually reviews call traffic reports and adjusts staffing levels to meet the needs of the business.
*This is a Remote role.
Primary Responsibilities

• The Customer Service Supervisor will handle inbound calls from physicians, hospitals and other medical provider representatives
• Supports and mentors the Team Leaders and SMEs as needed. Handles caller escalations and resolves as needed
• Continually monitors the teams call center metrics, quality assurance scores and productivity reports
• Assist the Customer Service Manager with performance reports, QA review sessions and re-training initiatives
• Manages departmental call activity and ensures appropriate staffing levels and scheduling to meet department KPI’s (Key Performance Indicators)
• Answers and handle call center calls when needed to ensure meeting KPI levels
• Conducts quality call monitoring review sessions with the Customer Service Manager to coach performance and identifies additional training needs
• Provides support to customer service representatives as needed
• Manages special projects and allocates resources as needed
• Collaborate with Network management team, Account Managers and Sales teams to gather feedback to enhance service performance
• Conducts impact analysis of any changes to service team operations to ensure internal customers are consulted and informed of pending operational changes prior to implementation
• Participate in activities designed to improve customer satisfaction and business performance
• Works with Customer Service Manager and Director to identify call reduction efforts and executes strategies accordingly
• Support projects and other departments in completing tasks when directed by management

Essential Qualifications

• The successful candidate will have experience in a high volume call center, experience with claims inquiry and claims review procedures, knowledge of medical specialties, fee schedules, complaints and appeals and call center responsibilities
• Previous experience in a physician’s office, group practice, clinic or hospital based practices. General knowledge of medical terminology, medical specialties and HIPAA Confidentiality laws

• Bachelor’s degree preferred, but not required
• HS diploma or GED is required
• Prior experience managing teams in a customer call center
• Experience managing call center volume through use of ACD systems
• Previous experience in quality call monitoring and performance coaching, counseling and progressive discipline
• Proficiency in healthcare transactions systems, CRMs, quality call tools and monitoring systems
• Ability to create staffing schedules and analyze call center volume, trends to Knowledge of basic computer operations
• Intermediate knowledge of Microsoft Office including Word, Excel, Access, Powerpoint and Outlook
• Strong time management skills
• Knowledge of CPT codes, ICD-9 Ability to learn quickly
• Knowledge of managed care procedures, claims payment policies
• Courteous with strong customer service orientation
• Previous multi-channel experience (i.e. voice, email, and chat) a plus

About

At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.

Come be a part of the Brightest Ideas in Healthcare™.

Company Mission

Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision

Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.
JOB ALERT FRAUD:  We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information.  Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section.  If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to: recruiting@brightonhps.com

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