Supervisor CS Tech Support

Moda Health•Milwaukie, OR

7d•Hybrid

About The Position

Let’s do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together. Position Summary Provide supervision to a team of customer service schedulers, auditors, and representatives responsible for handling inquiries via phone and email. Ensure timely, professional, and accurate responses to members, brokers, providers, sales, and other stakeholders. Set team goals, allocate resources, coach and develop staff, and monitor performance, including evaluating reports and results, to ensure service excellence and achievement of departmental objectives. This is a FT hybrid position based in Milwaukie, Oregon. Pay Range $71,990.85 - $89,988.57 annually (depending on experience) This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. https://j.brt.mv/jb.do?reqGK=27772905&refresh=true

Requirements

High school diploma or equivalent.
2-4 years of experience in quality assurance, claims, or customer service; experience in medical, pharmacy or dental preferred.
In-depth knowledge of benefits, claims processing, appeals, and referrals, with the ability to communicate accurate information to staff and stakeholders.
Strong verbal, written, and interpersonal communication skills, including the ability to manage difficult conversations and resolve conflicts.
Effective presentation and leadership communication skills, with the ability to collaborate with upper management.
Strong analytical, problem-solving, decision-making, and organizational skills.
Proficiency in Microsoft Office and customer service software, including NiCE.
Excellent time management skills with the ability to prioritize tasks, meet deadlines, and maintain consistent, reliable, and punctual attendance.
Ability to work effectively under pressure, manage multiple priorities, and adapt to frequent interruptions and changing demands.
Ability to solve problems quickly and identify opportunities for process automation.
Maintain confidentiality and project a professional business presence.

Responsibilities

Oversee multiple customer service mailboxes, manage inventory, and meet turnaround times.
Monitor call center performance, including scheduling and analyzing detailed reports.
Handle escalated inquiries and issues from internal customers or business departments.
Monitor staff to ensure quality and confirm that all collateral work resulting from phone calls, emails, online chats, post-contact surveys, and internal customer requests is completed and followed up on promptly.
Monitor staff's adherence to procedures and evaluate performance metrics, including training, orientation, and monthly statistics, to ensure quality and consistency.
Provide regular performance feedback and guidance to staff.
Oversee personnel administration, including timekeeping, performance appraisals, interviewing, hiring, and coaching.
Coordinate with Training and Operations on multi-skill training for new and existing staff.
Ensure policies and procedures are reviewed and updated annually; create new policies as needed.
Collect and analyze online communications for NCQA reporting to ensure compliance with accreditation standards.
Investigate and report issues related to the Member Dashboard, eBill, and other web platforms.
Act as a subject matter expert across all customer service lines and contact channels, including Member Dashboard and Benefit Tracker Admin inquiries.
Maintain comprehensive knowledge of benefits, claims processing, appeals, and referrals to support staff and ensure accurate information sharing.
Analyze new group and individual plan benefits and communicate relevant updates to staff.
Collaborate with departments such as Benefit Configuration, Membership Accounting, Professional Relations, Sales and Account Services, and Privacy to clarify benefits and resolve group-related issues.
Identify and implement process improvements to ensure departmental efficiency; evaluate and modify as needed.
Recommend operational and support enhancements.
Perform other duties as assigned.