Claims Customer Service Supervisor

Atlantic American Corporation•Brookhaven, GA

About The Position

The Customer Service Representative (“CSR”) Supervisor play a pivotal leadership role that embodies Bankers Fidelity’s mission to provide security and stability through exceptional insurance solutions. The CSR Supervisor role is responsible for overseeing daily operations and customer service call handling for Medicare Supplement and Ancillary claim inquiries, ensuring every interaction reflects Bankers Fidelity’s commitment to accuracy, integrity, empathy and professionalism. The CSR Supervisor guides and mentors a team of CSRs, prioritizes customer needs, resolves escalated issues, monitors quality assurance, analyzes performance metrics, and collaborates with other departments to ensure seamless service delivery and effective communication with all stakeholders. The CSR Supervisor is instrumental in driving team performance, enhancing customer satisfaction, and upholding Bankers Fidelity’s values in every customer interaction.

Requirements

3+ years of experience in a healthcare customer service role, with at least 1 year in a supervisor position.
Proven experience in a supervisory or leadership role within a customer service environment, preferably in the healthcare industry.
Demonstrated ability to monitor, evaluate and improve team performance through quality assurance and performance metrics.
Strong skills in managing escalated customer issues and resolving conflicts with empathy and professionalism.
Experience in identifying and implementing process improvements to enhance operational efficiency and service quality.
Strong verbal and written communication skills to clearly convey information and instructions.
Proficiency in identifying issues, developing solutions, and resolving conflicts in a professional manner.
Ability to manage multiple tasks efficiently and prioritize workload in a fast-paced environment.
Advanced skills in using customer service software, databases, and related tools.
Experience in conducting training sessions and developing training programs to enhance team skills and knowledge.
Strong ability to analyze performance metrics, prepare reports and provide actionable insights.
Capability to adapt to changing circumstances and work effectively, in a dynamic environment.
Deep understanding of customer service principles with a commitment to providing exceptional service.
Keen eye for detail to ensure accuracy in claims adjudication and policyholder/provider interactions.
High school diploma or equivalent; associate or bachelor’s degree preferred.

Responsibilities

Team Management:
Supervise and lead the CSR team, providing guidance, support and mentorship, fostering a culture of respect, inclusivity and accountability.
Manage escalated customer service issues with empathy and professionalism, ensuring timely and effective resolutions.
Track and analyze team performance metrics, ensuring high quality assurance scores and continuous improvement.
Implement training programs and development initiatives to enhance team skills and knowledge.
Establish clear performance goals and expectations for the team, aligning with company objectives.
Provider regular feedback and coaching to CSRs to improve performance and address areas of growth.
Organize team building activities and initiatives to strengthen collaboration and morale.
Customer Service Operations:
Supervise daily customer service operations, ensuring timely and accurate response to Medicare Supplement and Ancillary claim inquiries ensuring efficient workflow and timely responses.
Handle complex issues, claim escalations and complaints, providing effective solutions while maintaining customer satisfaction.
Monitor and maintain high standards of service quality, ensuring accuracy and professionalism in all interactions.
Identify and implement strategies for operational improvements and increased efficiency within the customer service department.
Ensure adherence to company policies, regulatory guidelines, and industry best practices in all customer service activities.
Customer-Centric Focus:
Ensure all customer interactions are handled with accuracy, empathy and professionalism, providing timely and effective solutions that enhance customer satisfaction.
Foster a culture of customer-centricity within the team, encouraging CSRs to prioritize the needs and concerns of policyholders, providers and other stakeholders.
Ensure the CSRs are equipped to provide detailed and accurate information about Medicare Supplement benefits, insurance claims, and policy provisions, enhancing the overall customer experience.
Assist CSRs in achieving one-call resolution, ensuring that customer inquiries are addressed promptly and effectively, thereby improving customer satisfactions and operational efficiency.
Continuously seek ways to improve customer experience, implementing best practice innovative solutions to meet and exceed customer expectations.
Guide the team in gathering and analyzing customer feedback and QA scores to continuously improve service quality and customer satisfaction.
Quality Assurance and Performance Metrics:
Achieve and maintain high customer satisfaction scores of 95% and above, ensuring exceptional service delivery.
Monitor and manage call abandonment rates, implement strategies for reduction and ensure customer calls are answered promptly.
Ensure high standards of service quality are maintained by regularly monitoring and evaluating CSR performance.
Analyze performance metrics to identify trends, areas for improvement, and opportunities for enhancing service delivery.
Implement feedback from quality assurance evaluations to drive continuous improvement in customer service practices.
Develop and conduct training sessions focused on quality assurance and performance enhancement.
Continuous Improvement:
Regularly evaluate existing processes to identify inefficiencies and areas for improvement.
Implement innovative strategies and solutions to enhance operational efficiency and service quality.
Integrate feedback from customers and team members into continuous improvement initiatives, improve workflows, systems and procedures.
Use performance metrics to track progress and measure the impact of improvement efforts.
Stay informed about industry trends, best practices, and regulatory changes to ensure the customer service team remains current, effective and compliant.
Develop and conduct training programs focused on continuous improvement and skill enhancement.
Stakeholder Collaboration:
Maintain clear and proactive communication with internal and external stakeholders, including policyholders, providers, beneficiaries, and agents to ensure effective issue resolution.
Collect and analyze information from stakeholders to address concerns and improve service delivery.
Collaborate with other departments to ensure seamless service delivery and address customer needs efficiently.
Foster strong relationships with stakeholders to build trust and ensure ongoing collaboration.