Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.
Supervise and provide guidance to Customer Service Representatives regarding department policies, procedures, and workflow. Responsible for hiring, mentoring, coaching and evaluating team members’ performance. Demonstrate effective leadership to improve individual performance and develop teamwork and team support. Manage change and encourage collaborative relationships, involvement and initiative.
Essential Responsibilities:
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Provide supervision, coaching, training, support, evaluation and leadership to assigned staff.
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Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
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Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
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Monitor, evaluate and report service performance for the department and determine staffing needs related to day-to-day performance goals.
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Investigate and settle issues not resolvable by customer service representatives. Relay information for dispute resolution to appropriate departments and personnel.
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Assist with answering inquiries received by phone, mail, e-mail or in person, providing exceptional service.
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Assist in appeal research and resolution.
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Coordinate business activities by maintaining collaborative partnerships with key departments.
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Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
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Actively participate as a key team member in department meetings.
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Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
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Serve as back-up to the Customer Service Manager as needed.
Supporting Responsibilities:
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Maintain department visual board.
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Meet department and company performance and attendance expectations.
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Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
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Perform other duties as assigned.
SUCCESS PROFILE
Work Experience:
Two years medical insurance or other healthcare related field preferred. Prior customer service/call center experience preferred. Claims processing preferred. Experience in leadership preferred.
Education, Certificates, Licenses: High School Diploma or equivalent required.
Knowledge: Computer Skills, Typing and 10-key required. Medical terminology, CPT & ICD-9 coding preferred, Microsoft word/excel preferred.
Competencies:
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Compensation Disclaimer
The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.
Base Range:
$50,830.78 - $81,329.23
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
