Team Lead- Member and Provider Service Job Wheeling area,West Virginia USA,Customer Service/HelpDesk

Job Title

Team Lead - Member and Provider Service

Job Summary

Peak Health at WVU Medicine seeks a Team Lead for Member and Provider Service. This position reports to the Service Manager and serves as a primary contact for employees and managers within Peak Health. The Team Lead reviews and monitors general customer and provider inquiries via chat, calls, and service requests, acts as a point of contact for escalations, and ensures customer satisfaction.

The role also handles training of new team members and lays a foundation for those interested in Management.

Core Duties and Responsibilities

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

Acts 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.

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

Monitor progress towards specialist readiness.

Leads training efforts and ensures all updates to materials.

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

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

Responsible for ensuring appropriate coverage for chat inquiries and call coverage during lunch.

Responds 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.

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

Answers inquiries by clarifying desired information; researches, locates and provides information.

Resolves problems by clarifying issues; researches and explores answers, and alternative solutions; escalates unresolved problems to supervisor.

Anticipates and responds to customer needs; follows up until needs are met; maintains proactive contact with customers to ensure awareness of service request status until resolution.

Coordinates other service support activities as assigned by the manager.

Minimum Qualifications

Education and experience:

High school diploma or equivalent AND five (5) years of experience in customer service support
Associate degree AND three (3) years of experience in customer service support
Bachelor’s degree AND two (2) years of experience in customer service support

Experience:

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

Preferred Qualifications

Bachelor’s Degree, or greater, in related healthcare field.

One (1) year of experience with Peak Health Member and Provider Service.

Five (5) years of service experience, preferably in call center environment.

Three (3) to (5) years’ experience in health insurance.

Three (3) years’ experience in commercial, Medicare, and Medicaid plans.

Three (3) years of working in a metric driven environment.

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 the number of 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.

Job Details

Scheduled Weekly

Hours:

40. Shift: Exempt/Non-Exempt:
United States of America (Non-Exempt). Company: PHH Peak Health Holdings. Cost Center: 2911 PHH Member Services.

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