Overview:
The Team Lead is responsible for engaging with the team member(s), program managers and other departments within the organization to support all operational activities, ensure efficient day-to-day operations and provide ongoing program metrics for customer business review meetings.
Responsibilities:
- Continuous monitoring of existing processes and analyzing their effectiveness.
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Review service trends and collaborate on priorities and next steps to improve productivity and efficiencies within Patient Solutions.
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Utilizes historical program and operational data to identify opportunities, trends/patterns, and behaviors to present recommendations on program enhancements, process changes or areas to expand our service offerings.
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Prepares program reports reflecting actual performance against KPI s and SLA s
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Monitor team workload to ensure timely completion of tasks.
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Review the creation of staffing model recommendations prior to presenting to leadership to ensure leader is presented with best and worst-case scenarios.
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Prepare periodic analysis on shift change request activity which includes shift swaps, shift adjustments, PTO, and VTO by team members for leadership review.
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Ensure consistency of processes, optimization of workforce and achievement of performance metrics.
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Collaborate on the design, roll-out and maintenance of reward and recognition programs.
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Assist with the development of policies and procedures for the department.
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Identify and report adverse events pursuant to program requirements.
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Identify, document, and report safety information.
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Additional responsibilities as needed based on department, program and project requirements.
Qualifications:
- High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience.
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Strong working knowledge of Microsoft Office Suite and pharmacy/healthcare systems; experience with CRM and case management tools is a plus.
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Proven experience in benefit investigation and insurance verification, including interpreting coverage and working with various insurance types (Commercial, Medicare Part D, Medicaid, etc.).
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Demonstrated ability to interact professionally with healthcare providers, patients, and internal teams to resolve complex insurance and service issues.
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Previous exposure to enrollment, pre-assessment, and benefits investigation workflows.
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Experience in call center, health insurance, or medical office environments preferred.
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Excellent problem-solving, communication, and conflict resolution skills.
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Ability to coach, train, and support team members to meet and exceed performance standards.
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Exhibit initiative and the ability to adapt in a fast-paced environment.
Pay Range: USD $26.33 - USD $32.91 /Hr.
