Sr Sup Customer Care Call CtrBlue Cross Blue Shield - Chicago, IL (Consumer Services)This position is responsible for managing staff engaged in managed care call center activities and support various full service units managed care customer inquiries; and manage support staff for quality auditing, administrative duties, inventory reporting and clerical functions. JOB REQUIREMENTS: * Bachelor Degree in Business or Health Care Administration or 4 years experience in the health care industry. * 3 years experience in health insurance in a managed care program. * 2 years supervisory experience in a call center. * Experience in Customer Service setting. * Knowledge of managed care program policies and procedures. * Knowledge of ADS programs and networks. * Knowledge of union contract and administration guidelines. * Ability to interface across organizational lines with members and providers. * Organizational skills with ability to manage multiple priorities and meet deadlines. * Verbal and written communication skills; facilitation skills. * PC proficiency to include Word, Excel, PowerPoint and Lotus Notes. PREFERRED JOB REQUIREMENTS: * Experience with Blue Chip, CICS, Image, Claims or member and provider systems. BASIC FUNCTION: (Health Care Management)This position is responsible for direct supervision of the Customer Service Representative, Clinical Review Analyst, Medical Record Assistant, and System Interface Analyst staff in the Customer Care Call Center. Also responsible for the evaluation of service levels, staff education, and special projects; response to claim inquiries, waiver requests both clinical and geographic, Level III claim check review, clinical retrospective medical reviews, and network steerage of members/providers; drafting, editing, and annual review of the departmental Internal Policies and Procedures relative to workflows and processes for compliance with accreditation and recent legislation; ensuring all training materials are updated and reflect the current practices with the department; and assisting in the direction, coordination and managing of the internal administrative functions adhering to the service and the financial goals established for the department. JOB REQUIREMENTS: * Bachelor Degree in Health Care Administration, Business Administration, or 4 years experience in the health care industry. * 3 years experience in health insurance and health care delivery and financing. * 2 years supervisory experience in a call center. * Knowledge of managed care program policies and procedures. * Knowledge of health care delivery and financing systems, and financial techniques. * Knowledge of ACD telephone systems and telephone tiering. * Clear and concise interpersonal, verbal and written communication skills. * PC proficiency to include Word, Excel, PowerPoint and Lotus Notes. PREFERRED JOB REQUIREMENTS: * Clinical Experience hcsc/search.html Job ID: DP-1004633
Posted on: Tue, 30 Dec 2014 14:09:01 +0000