What are the responsibilities and job description for the Supervisor, Claims Call Center position at Independent Living Systems?
About the Role:
We are seeking a highly skilled Supervisor for the Claims Call Center to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. The Supervisor, Claims Call Center plays a crucial role in ensuring the efficient processing and resolution of claims within the health care services industry. This position is responsible for overseeing a team of representatives, providing guidance and support to enhance their performance and customer service skills. The Supervisor, Claims Call Center will analyze call center metrics to identify areas for improvement and implement strategies to optimize workflow and productivity. Additionally, this role involves collaborating with other departments to address complex claims issues and ensure compliance with industry regulations. Ultimately, the supervisor's leadership will contribute to a high level of customer satisfaction and operational excellence in claims processing.
Minimum Qualifications:
- Bachelor's degree in a related field or equivalent work experience.
- Minimum of 3 years of experience in a call center environment, preferably in health care services.
- Proven leadership experience with the ability to motivate and manage a team.
- Relevant experience may substitute for the educational requirement on a year-for-year basis.
Preferred Qualifications:
- Master's degree in a related field or equivalent work experience.
- Experience with claims processing and knowledge of health care regulations.
- Familiarity with call center software and performance management tools.
- Certification in health care management or related field.
Responsibilities:
- Oversee daily operations of the claims call center, ensuring adherence to policies and procedures.
- Provide training, coaching, and performance evaluations for claims representatives to enhance their skills.
- Monitor call center metrics and generate reports to assess team performance and identify areas for improvement.
- Resolve escalated claims issues and facilitate communication between representatives and other departments.
- Implement process improvements to enhance efficiency and customer satisfaction in claims handling.
Skills:
Strong leadership skills are essential for guiding the epresentatives and fostering a positive work environment. Excellent communication skills are required to effectively interact with team members, providers, and other departments to resolve claims issues. Analytical skills are utilized to assess call center metrics and develop strategies for improvement. Problem-solving abilities are crucial for addressing complex claims situations and ensuring compliance with regulations. Additionally, proficiency in technology and software tools enhances the supervisor's ability to manage operations efficiently and track performance metrics.
