What are the responsibilities and job description for the Health Insurance Customer Service Manager position at PayerFusion?
AboutUsPayerFusion Holdings, a licensed Third-Party Administrator, is currently seeking a Customer Service Manager to join our dynamic team. Specializing in managing U.S.-based clients who have purchased International Health Insurance plans, we take pride in our decade-long experience in the industry. Our headquarters are located in Coral Gables, Florida.As a Customer Service Manager at PayerFusion Holdings, you will be at the forefront of our commitment to delivering top-notch customer service. Your responsibilities will include overseeing daily customer service operations, resolving complex issues, team training, claims management, and more.About the PositionThe Customer Service Manager is responsible for overseeing the day-to-day activities of the Customer Service Department and ensuring the company delivers the highest level of customer service possible.
- Thoroughly research and appropriately respond to all verbal and written requests for assistance from clients, providers of service, and any other request as needed via phone or email.
- Identify problems / trends and assist the General Manager in creating and documenting resolutions. Recommend procedures and controls for problem prevention. Provide input for changes and process improvements.
- Prioritize workload and monitor coordinator's productivity.
- Work closely with Claims and Case Management Department to resolve complex, escalated issues.
- Train staff on departmental tasks, procedures and processes as needed. Train new staff and continuously monitor work during probationary period. Provide scripts to read from during phone calls.
- Assist with departmental metric reporting.
- Develop and maintain departmental procedures.
- Monitor time-off requests and timecards for payroll purposes. Work directly with the General Manager to always maintain the highest level of phone resources.
- Implement client service level agreements.
- Assist the General Manager with the completion of employee performance reviews.
- Ensure compliance with HIPAA and other regulatory and legal guidelines and troubleshoot and resolve customer / client service issues.
- Perform Quality Assurance call reviews.
- Take live calls when call volume mandates.
- Fulfills departmental requirements in terms of providing work coverage and administrative notification during periods of personnel illness, vacation, or education.
- Create seamless operations between departments.
- Report accomplishments as well as inefficiencies to manager
- Perform other similar and related duties as required.Job Requirements
- Associate's degree in a related field, or equivalent combination of education and work experience.
- A minimum of 3 year experience in a Manager or Lead role involving health insurance benefits. Call center experience is preferred.
- Experience in management of a small call center.
- Experience in Benefits Administration (claims processing, auditing, and / or configuration / programming) preferred.
- Ability to read & interpret Medical and Dental benefit plans.
- Excellent analytical and problem resolution skills and ability to maintain high attention to detail are required.
- Must have excellent verbal and written communication and interpersonal skills to interface with all levels of the organization and clients.
- Strong decision-making and organizational skills, with the ability to optimize the use of all available resources and deliver on multiple priorities.
- Exceptional team player with the confidence and integrity to earn client and internal team confidence quickly.
- Proficient PC skills including intermediate to advanced Microsoft Word, Excel and Outlook skills. PowerPoint experience preferred.
- Knowledge of ICD and CPT coding a plus.
- Ability to work varying shiftsBenefits
- We provide a great culture and competitive salary.
- We provide excellent health, dental and vision insurances. 401K and other supplemental benefits such as Life insurance and Hospitalization plans.
- We also provide of time off (vacation / sick and 12 paid holidays)
