Supervises, trains, coaches, and develops the Patient Service Representative team. Supervises the daily operations and oversees daily outcomes in the Customer Service Contact Center. This position ensures compliance with the Veteran Affair’s Patient-Centered Community Care (VAPCCC) requirements, and TriWest policies, and procedures. Ensures accurate completion of VA-approved medical authorizations, appointment scheduling, thorough documentation of all Veteran and provider encounters in the TriWest medical management system and receipt of timely medical documentation from network providers. Directly interacts with a variety of internal and external customers daily. Works in a detailed, multi-tasked and fast-paced production environment. Reports to the Director, Customer Service.
Monitors Contact Center performance levels, identifies training needs, and develops action plans for staff development. Monitors telephone system's real-time reports to ensure department service levels and contract requirements are met.
Reviews medical management data entries for clarity of documentation and appropriate handling of encounters and inquiries.
Counsels individual employees on job performance issues. Develops and monitors progress on employee Performance Improvement Plans. Drafts performance evaluations for management review. Alerts management and consults with Human Capital on performance and behavior issues.
Ensures internal standards, guidelines and procedures are in place to achieve/maintain high customer service and performance levels. Ensures Patient Service Representative Team follows system protocols for data entry edits and corrections.
Provides for adequate coverage of Contact Center using Workforce Management system to plan and adjust employee work schedules.
Assists with the employee selection process, coordinates the training of new employees, and assists with Contact Center training initiatives.
Conducts staff meetings and provides clear communication regarding any changes/issues affecting the Contact Center or team members.
Assists Contact Center staff with customer contacts requiring supervisory intervention.
As needed performs all Team Lead and Patient Service Representative duties, while providing contact center operational oversight and direction to staff.
Performs other duties as assigned
Education & Experience
High School Diploma or G.E.D.
3+ years experience in a customer service environment
2 years supervisory or leadership experience
Supervisory experience in an inbound call center environment
College education or equivalent
Knowledge of medical terminology
Managed Care experience
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