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About The Role

Brighton Health Plan Solutions is seeking an experienced Customer Service Supervisor to manage the company’s service operations for members and providers and high traffic call center. The Supervisor directly manages the daily performance activity of the Customer and/or Provider Service call center representatives to ensure customer satisfaction and achievement of the department’s Key Performance Indicators (KPI’s). The Supervisor continually reviews call traffic reports and adjusts staffing levels to meet the needs of the business.

Primary Responsibilities

+ Handles inbound calls from medical providers and resolves escalations.

+ Mentors Team Leaders and SMEs, monitoring call center metrics and quality.

+ Assists the Customer Service Manager with reports and re-training.

+ Manages call activity, staffing, and scheduling to meet KPIs.

+ Conducts quality call monitoring and provides support to representatives.

+ Manages special projects and collaborates with other teams.

+ Conducts impact analysis of operational changes and improves customer satisfaction.

+ Identifies call reduction strategies and supports projects as directed by management.

Essential Qualifications

+ Experience in a high-volume call center, including claims inquiry and review procedures, medical specialties, fee schedules, complaints and appeals, and call center responsibilities.

+ Previous experience in a healthcare setting with knowledge of medical terminology, specialties, and HIPAA Confidentiality laws.

+ A Bachelor's degree is preferred but not required; a high school diploma or GED is necessary.

+ Prior experience in managing teams in a customer call center.

+ Proficiency in managing call center volume using ACD systems.

+ Experience in quality call monitoring, coaching, and progressive discipline.

+ Proficiency in healthcare transaction systems, CRMs, and monitoring tools.

+ Strong time management skills and basic computer operations knowledge.

+ Intermediate knowledge of Microsoft Office.

+ Familiarity with CPT codes, ICD-9, and managed care procedures.

+ Courteous with a strong customer service orientation.

+ Previous multi-channel experience (voice, email, and chat) is a plus.

*General Knowledge of HIPAA Confidentiality Laws

About

At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities.

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes, and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions. Come be a part of the Brightest Ideas in Healthcare™.

Company Mission

Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision

Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.

DEI Purpose Statement

At BHPS, we encourage all team members to bring your authentic selves to work with all your unique abilities.   We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace.  We are building, nurturing, and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level.

*We are an Equal Opportunity Employer

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