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Resp & Qualifications

PURPOSE:

Supervise and provides daily direction to multi-functional team members regarding training and development, policies, procedures, and work production quantity and quality. Functional areas may include but not limited to: installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. Reviews and resolves complex service issues not resolvable by subordinates.

ESSENTIAL FUNCTIONS:

+ Supervise employee outcomes by training, assigning, scheduling, coaching, and counseling employees; communicating job expectations; planning, monitoring, and appraising job contributions; adhering to policies and procedures.

+ Meets operational standards by contributing information to strategic plans and reviews; implementing production, productivity, quality, and customer-service; resolving problems; identifying system improvements.

+ Maintains customer service objectives by monitoring daily operations; resolving claims that require manual review or technical support, enrollment or billing related customer issues. Consistently reviews systems and makes necessary adjustments where needed, including resources/staffing. Researches and resolves escalated calls, review and resolve complex claims that have not been resolved by Claims staff.

+ Maintains and improves departmental operations by monitoring system performance; identifying and resolving operations problems; supervising process improvement and quality assurance programs; installing upgrades.

+ Prepares call center, claims and or enrollment and billing performance reports by collecting, analyzing, and summarizing data and trends.

+ Improves call center, claims and or enrollment and billing job knowledge by attending educational workshops.

SUPERVISORY RESPONSIBILITY:

This position manages people.

QUALIFICATIONS:

**Education Level:** High School Diploma or GED

Education Details: or GED

**Experience:** 3 years related professional experience with demonstrated leadership skills. Must have proficiency in the service, claims or enrollment & billing area.

**Preferred Qualifications** :

+ Bachelor's Degree

+ Familiarity with Facets G6 Platform

+ Experience with CMS Mandates and/or Audits

Knowledge, Skills and Abilities (KSAs)

+ Knowledge of call center operations, claims and/or enrollment and billing and work flows.

+ Strong presentation skills.

+ Highly proficient in Microsoft Office programs.

+ Excellent communication skills both written and verbal.

+ Ability to plan, review, supervise, and inspect the work of others.

Salary Range: $62,856 - $129,641

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Medicare/Medicaid Admin

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship.

\#LI-AB1

REQNUMBER: 21297