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Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

Supervise and provide guidance to Customer Service Representatives regarding department policies, procedures, and workflow. Responsible for hiring, mentoring, coaching and evaluating team members’ performance. Demonstrate effective leadership to improve individual performance and develop teamwork and team support. Manage change and encourage collaborative relationships, involvement and initiative.

Essential Responsibilities:

• Provide supervision, coaching, training, support, evaluation and leadership to assigned staff.
• Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
• Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
• Monitor, evaluate and report service performance for the department and determine staffing needs related to day-to-day performance goals.
• Investigate and settle issues not resolvable by customer service representatives. Relay information for dispute resolution to appropriate departments and personnel.
• Assist with answering inquiries received by phone, mail, e-mail or in person, providing exceptional service.
• Assist in appeal research and resolution.
• Coordinate business activities by maintaining collaborative partnerships with key departments.
• Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
• Actively participate as a key team member in department meetings.
• Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
• Serve as back-up to the Customer Service Manager as needed.

Supporting Responsibilities:

• Maintain department visual board.
• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

SUCCESS PROFILE

Work Experience:

Two years medical insurance or other healthcare related field preferred. Prior customer service/call center experience preferred. Claims processing preferred. Experience in leadership preferred.

Education, Certificates, Licenses: High School Diploma or equivalent required.

Knowledge: Computer Skills, Typing and 10-key required. Medical terminology, CPT & ICD-9 coding preferred, Microsoft word/excel preferred.

Competencies:

Building Trust

Building a Successful Team

Aligning Performance for Success

Building Customer Loyalty

Building Strategic Work Relationships

Continuous Improvement

Decision Making

Facilitating Change

Leveraging Diversity

Driving for Results

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.

Skills:

Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and inte