Team Lead- Member and Provider Service Job Local Missouri USA,Customer Service/HelpDesk

Location: Local

Team Lead, Peak Health Member and Provider Service leads the Peak Health Service team to deliver high‑quality member and provider service through calls, chat and service requests.

This role reports to the Service Manager and serves as the primary point of contact for employees and managers within Peak Health, handling escalations, ensuring customer satisfaction, and training new team members to achieve competency in WVUHS and Peak Health policies and processes.

Minimum Qualifications

High school diploma or equivalent and 5 years of customer service support experience.
Associate degree and 3 years of customer service support experience.
Bachelor’s degree and 2 years of customer service support experience.

Experience

3 years of call center service environment experience.
2 years experience with service technologies including telephony, chat, CRM management, knowledge management, training, and documentation.
2 years experience in health insurance, medical environment.

Preferred Qualifications

Bachelor’s Degree or higher in a related healthcare field.

Preferred Experience

1 year of experience with Peak Health Member and Provider Service.
5 years of service experience, preferably in call center environment.
3 to 5 years’ experience in health insurance.
3 years’ experience in commercial, Medicare, and Medicaid plans.
3 years of working in a metric‑driven environment.

Core Duties and Responsibilities

Serve as a point of escalation for member and provider service manager calls.

Act as a single point of contact for higher level support inquiries for Peak Health.

Participate in meetings with other Peak Health departments to stay current on actions affecting Customer Service and Insurance workflows.

Act as a mentor to new team members and ensure new team member competency of policy and procedures of the role.

Monitor progress towards specialist readiness.

Lead training efforts and ensure all updates to materials.

Collaborate with team leadership to align the team with department and corporate goals through training and process management.

Regularly review escalated service requests for correct assignment, identifying activities that can become Customer Service knowledge areas.

Ensure appropriate coverage for chat inquiries and call coverage during lunch.

Respond to chats, calls and service requests from employees, managers in a timely manner with a customer focus and with the goal to resolve 90% of the inquiries on first contact.

Provide input and guidance to managers and employees regarding understanding of Peak Health policies, procedures, forms, and processes.

Answer inquiries by clarifying desired information; research, locate and provide information.

Resolve problems by clarifying issues; research and explore answers, and alternative solutions; elevate unresolved problems to supervisor.

Anticipate and respond to customer needs; follow up until needs are met. Maintain proactive contact with customers to ensure awareness of service request status until resolution.

Coordinate other service support activities as assigned by the manager.

Physical Requirements

Ability to sit for extended periods of time.

Working Environment

Standard office environment with electrical equipment (telephone, personal computer, copier, fax machines, etc.).
Computer Software/Systems include but not limited to Microsoft Office Professional Suite (Outlook, Word, Excel, Access), Internet Explorer, and EPIC.

Skills & Abilities

Exceptional customer service skills.
Ability to execute in a fast paced, high demand environment while balancing multiple priorities.
Effective interpersonal skills.
Familiarity with Health Insurance practices and procedures.
Ability to manage call volume and reduce abandoned calls to improve team performance metrics.
Excellent written and oral communication skills.
Proficiency with MS Office, Tapestry and other computer applications as required.
Ability to utilize search tools and knowledgebase tools to find relevant information.
Exercise good judgment in handling sensitive and confidential information and situations.

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