West Corporation Benefits Call Center Supervisor - Evening (10% Shift Differential) in Plymouth Meeting, Pennsylvania

Benefits Call Center Supervisor - Evening (10% Shift Differential)

Description

Available schedule: 3:30 pm -12:00 am (midnight)

Are you looking for an exciting opportunity within the healthcare benefits field? Do you have supervisory experience to bring to the table? If so, this opportunity may be for you! West’s Health Advocate Solutions is looking to add an evening Benefits Call Center Supervisor to its team in Plymouth Meeting. The core focus of this position is supervising workflow of all incoming benefits calls and cases including medical, dental, pharmacy, vision and other services. This includes developing and implementing policies and procedures, training staff, and managing employee performance, monitoring calls and auditing case files daily to ensure the proper target resolution is identified and that, if possible, the case is closed.

The ideal candidate will have experience and working knowledge with healthcare benefits in a call-center environment, as this supervisor role will support the needs and daily operations of a fast-paced, call-center staff.

Additional responsibilities include:

  • Implementing actions to resolve any case deficiencies which includes reviewing results with employees

  • Reviewing operational reports and analyzing staff needed and making the necessary adjustments and or plans to improve results, which includes adherence to hours worked, time spent resolving cases, and case documentation

  • Analyzing data reports to make timely decisions and effectively implementing plans

Qualifications

Applicants for this job will be expected to meet the following minimum qualifications:

Education

  • Associate's degree from an accredited college or university with major course work in business administration, liberal arts, public health, healthcare management, or a related field required

Experience

  • Minimum of 3 years of healthcare, health plan or benefits experience required preferably in a call center environment

  • Minimum one year lead or supervisor experience preferred

Based on department or area of assignment the following may be required:

  • Minimum 2 years of health benefits experience

Other

  • Intermediate knowledge of Word and Excel is required

  • Ability to search and identify resources through company Intranet and Internet

Based on department or assignment knowledge of the following is preferred:

  • Group Health Plans (fully insured and self-insured)

  • Summary Plan Documents (SPDs) and Certificates of Coverage (COCs)

  • Government programs, resources and legislation and mandates including but not limited to Affordable Care Act, FMLA, Medicaid, CHIP

  • COBRA

  • Medicare A, B, MediGap, Supplement plans, Medicare Advantage, Medicare Part D plans

  • High deductible health plans including Health Reimbursement Accounts (HRAs) and Health Saving Accounts (HSAs)

  • Flex Spending Accounts (FSA), including limited FSAs

  • Coordination of benefits and which plan is primary - simple and complex cases (commercial plans, Medicare plans)

  • Individual Health Plans and Exchanges plans

  • Reviewing, interpreting, and researching Explanation of Benefits (EOB's) and denial letters

  • Understanding of health plan authorizations, including medical policy and claims payment guidelines to evaluate if appeals require clinical or administrative review

  • Knowledge of applicable law and resources regarding confidentiality of privileged patient information and appeals administration

  • Understanding of insurance carrier claims processing

  • Knowledge of procedure and diagnosis coding (ICD-9, HCPCS, and CPT-4

  • Pharmacy benefits including injectable medications

West is connecting people and ideas.

We are delivering on their potential.

We are improving the way we work and live.

At West, we are dedicated to delivering and improving upon new channels, new capabilities and new choices for how businesses and consumers collaborate, connect and transact. We develop technology-enabled communications that change the way we work and improve the way we live. We are a collective effort of enterprise and individuals, of communities and customers, of partnerships and families. We are the sum of our entire network - the result of brilliant ideas, dedication and the hard work of people who share our vision. We are at the core of a technology and communications engine that is changing the world.

We connect. We deliver. We are West.

Applications will be accepted through 10/31 /17.

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Job Operations

Primary Location United States-Pennsylvania-Plymouth Meeting

Schedule Full-time

Organization Health Advocate USA

Req ID: 119518