Supervisor, Claims Call Center

Job Description

Job Description

We are seeking a Supervisor, Claims Call Center to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Supervisor, Claims Call Center plays a vital role in ensuring the efficient processing and resolution of claims for the organization. This position is responsible for supervising a team of representatives, providing guidance and support to enhance their performance and customer service skills. The Supervisor, Claims Call Center will analyze call center metrics to identify areas for improvement and implement initiatives to optimize workflow and productivity. Additionally, this role involves collaborating with other departments to address complex claims issues and ensure compliance with industry regulations. Ultimately, the Supervisor, Claims Call Center will contribute to a high level of provider satisfaction and operational excellence in claims processing.

Minimum Qualifications:

• Bachelor's degree in a related field or equivalent work experience.
• Minimum of 3 years of experience in a call center environment, preferably in health care services.
• Proven leadership experience with the ability to motivate and manage a team.
• Relevant experience may substitute for the educational requirement on a year-for-year basis.

Preferred Qualifications:

• Master's degree in a related field or equivalent work experience.
• Experience with claims processing and knowledge of health care regulations.
• Familiarity with call center software and performance management tools.
• Certification in health care management or related field.

Responsibilities:

• Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
• Lead and supervise a team of representatives, providing guidance and support to enhance their performance and customer service skills.
• Oversee daily operations of the claims call center, ensuring adherence to policies and procedures.
• Monitor call center metrics and generate reports to assess team performance and identify areas for improvement.
• Resolve escalated claims issues and facilitate communication between representatives and various departments.
• Collaborate with internal teams such as claims, credentialing, provider relations, and network management and other stakeholders to address audit findings and recommend corrective actions.
• Implement process improvements to enhance efficiency and customer satisfaction in claims and call handling.

• Perform other duties as assigned.