Customer Experience Team Lead

South Florida Community Care Network LLC•Sunrise, FL

1d•Hybrid

About The Position

Addresses escalated member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing calls from the ACD phone system. May run reports from the ACD call center system when required. Provides available information upon request and escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines.

Requirements

Minimum High School or GED Diploma.
Two (2) years HMO Health Care Plan Experience.
Familiar with a variety of the Call Center’s concepts, practices, and procedures.

Nice To Haves

Associate or bachelor’s degree preferred
Ability to maintain composure under pressure
Excellent customer service and team management skills
Outgoing energetic attitude
Excellent listening skills
Ability to multitask and problem solve in a fast-paced environment
Leads and directs the work of others.

Responsibilities

Addresses escalated member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care.
Trains, coaches and motivates team members in all aspects of call center service handling to include metrics, real-time performance feedback, behavior related to customer experience.
Creates and maintains training manual updated.
Responsibility for training of new Member Services Representative and conducts update training section to all department.
Conducts regular review of all call center agents’ performance and organize training sessions to respond to training and performance needs.
Schedules and organizes shift patterns for other team members to ensure that call center has adequate coverage.
Receives and directs calls from the ACD phone system to accessible resources.
Acts as the initial information source and answers questions, assigns tasks, follows up and gives instructions as needed.
Ability to manage urgent calls in such a way that urgent situations related to the provision of patient care are handled in an appropriate and prompt manner.
Ensures client satisfaction by providing prompt response and solutions to queries.
Prepares reports and supporting documentation as needed for review by Supervisor and Director of the Member Services Department.
Identifies and communicates calls/inquiries that require escalation calls to Call Center Supervisor and/or Director.
Ensures a safe and harmonious working environment for all other team members.