Role Description Come join our Peak Health team at WVU Medicine as a Team Lead for Member and Provider Service, contributing to the foundation for an innovative, new health plan. This position will report to the Service Manager, playing a unique and important role in our mission to change healthcare for the better. The Team Lead, Peak Health Member and Provider Service is a primary contact for employees and managers within Peak Health Service. Responsibilities include: - Reviewing and monitoring general customer and provider inquiries via chat, calls, and service requests. - Being a point of contact for employee escalations and ensuring customer satisfaction. - Accountable for new team member training to ensure specialists are competent in WVUHS and Peak Health policies and processes. - Providing foundational experience for anyone looking to move into Management. Qualifications - High school diploma or equivalent AND five (5) years of experience in customer service support OR - Associate degree AND three (3) years of experience in customer service support OR - Bachelor’s degree AND two (2) years of experience in customer service support. Requirements - Three (3) years of call center service environment experience. - Two (2) years of experience with service technologies including telephony, chat, CRM management, knowledge management, training, and documentation. - Two (2) years of health insurance, medical environment experience. Preferred Qualifications - Bachelor’s Degree, or greater, in related healthcare field. - One (1) year of experience with Peak Health Member and Provider Service. - Five (5) years of service experience, preferably in call center environment. - Three (3) to (5) years’ experience in health insurance. - Three (3) years’ experience in commercial, Medicare, and Medicaid plans. - Three (3) years of working in a metric driven environment. Core Duties and Responsibilities - Serve as a point of escalation for member and provider service manager calls. - Act as a single point of contact for higher level of support inquiries for Peak Health. - Participate in meetings with other Peak Health departments to stay current on actions affecting Customer Service and Insurance workflows. - Act as a mentor to new team members and ensure new team member competency of policy and procedures of the role. - Monitor progress towards specialist readiness. - Lead training efforts and ensure all updates to materials. - Collaborate with team leadership to align the team with department and corporate goals through training and process management. - Regularly review escalated service requests for correct assignment, identifying activities that can become Customer Service knowledge areas. - Ensure appropriate coverage for chat inquiries and call coverage during lunch. - Respond to chats, calls, and service requests from employees and managers in a timely manner with a customer focus. - Provide input and guidance to managers and employees regarding understanding of Peak Health policies, procedures, forms, and processes. - Answer inquiries by clarifying desired information; research, locate, and provide information. - Resolve problems by clarifying issues; research and explore answers, and alternative solutions; escalate unresolved problems to supervisor. - Anticipate and respond to customer needs; follow up until needs are met. - Coordinate other service support activities as assigned by the manager. Physical Requirements - Ability to sit for extended periods of time. Working Environment - Standard office environment with electrical equipment (i.e., telephone, personal computer, copier, fax machines, etc.). - Computer Software/Systems include but not limited to Microsoft Office Professional Suite (Outlook, Word, Excel, Access), Internet Explorer, and EPIC. Skills & Abilities - Exceptional customer service skills. - Ability to execute in a fast-paced, high-demand environment while balancing multiple priorities. - Effective interpersonal skills. - Familiarity with Health Insurance practices and procedures. - Ability to manage call volume and reduce the number of abandoned calls to improve team performance metrics. - Excellent written and oral communication skills. - Proficiency with MS Office, Tapestry, and other computer applications as required. - Ability to utilize search tools and knowledgebase tools to find relevant information. - Exercise good judgment in handling sensitive and confidential information and situations. Additional Job Description - Scheduled Weekly Hours: 40 - Shift: Exempt/Non-Exempt - United States of America (Non-Exempt) - Company: PHH Peak Health Holdings - Cost Center: 2911 PHH Member Services