Job Title - HealthPlan Services
|Job Title |Manager, Customer Care |
| |MNA102 |
|Primary Function/Core Job |Position is responsible for the management of Customer Care Department. |
|Responsibilities |Responsibilities include: |
| |Overall responsibility of customer care team to meet production and quality goals. |
| |Responsible for ensuring the team is within regulatory turnaround times as well as client contract requirements. |
| |Responsible for adjusting available staffing to meet needs due to absences and vacations. |
| |Overall responsibility for monitoring the backlogs and reporting key metrics to the carrier. |
| |Requires knowledge of health insurance regulations. |
| |Handles agent inquiries and complex claim issues. |
| |Close relationship with the carrier and works with them |
| |to identify and implement new procedures and processes to improve department efficiencies or as instructed by the carrier. |
| |Ability to travel to client sites, conferences, etc. |
| | |
|Minimum Education & Experience |HS. |
| |Bachelors preferred. |
| |5+ years experience in related field. |
| | |
|Expertise |Diverse problems that require interpretation of administrative and/or technical issues. |
| |Design, plan and execute project related tasks. |
| |Designs and documents procedures. |
| | |
|Accountability and Supervision |Must have effective supervisory skills: planning, organizing, monitoring and coaching. |
| |Demonstrated proficiency in leadership. |
| |Several administrative and/or technical duties. |
| |Provides guidance, information and/or services. |
| |Decisions and actions may have a direct impact on the performance or staff function objectives. |
| |Considerable discretion as to work details. |
| |Responsible for timely project completion. |
|Job Knowledge |Requires specialized knowledge where problems, assignments, and/or duties are difficult but related. |
| |Thinking is independent but structured by broad principles and/or procedures. |
| |Individual performance of or supervision of several different activities. |
| |Requires integration and coordination of work. |
| |Procedural knowledge essential. |
| |Thorough understanding of bookkeeping and accounting practices. |
| |High aptitude for working with numbers. |
|Physical Work Environment |Normal degree of physical effort in typical office environment with comfortable, constant temperatures and absence of |
| |objectionable elements. |
| |May be subject to interruptions. |
| |Minimal physical exertion required. |
| |Required to work computer. |
| | |
|Computer skills |Proficient with Microsoft Word, and Excel, Outlook as well as claims processing software. |
| |Experience with internal systems including TAS, CSR Desktop and ER/NERD for processing role. |
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