Hawaii Medical Service Association Customer Service Supervisor (Claims) in Kapolei, Hawaii

Company:Hawaii Medical Service Assn.Job Title:Customer Service Supervisor (Claims)Exempt or Non-Exempt:ExemptIsland:OahuCity:KapoleiLocation:KapoleiEmployment Type:Full TimeJob Summary:Position requires working in both Kapolei and Honolulu locationsThe Customer Service Supervisor is responsible for mentoring, coaching, and providing direction to staff in the operational area which services customer calls and inquiries. The Supervisor also monitors the processing and adjudication of claims and inquiries to ensure performance objectives are met. The Customer Service Supervisor monitors inquiries and requests from members, providers, and other Blue Cross Blue Shield plans to ensure servicing and performance objectives are met.The Customer Service Supervisor provides guidance and collaborates with internal departments on high profile, special consideration, appeals, sensitive cases to ensure appropriate responses and timely resolution of these cases.The Customer Service Supervisor also supports the implementation of changes to the operational areas due to business initiatives, system enhancements, and process improvements.Duties and Responsibilities:

  • Resource Management

  • Select, train, and develop knowledge, job skills, and core competencies of the staff to maximize productivity and meet the unit’s objectives.

  • Monitors customer service calls for compliance, accuracy, identification of training opportunities, and provide ongoing feedback to the staff

  • Following the corporate Performance Management Program (PMP) process, establish individual objectives and performance standards that support the unit, department, and corporate goals. Provide feedback and coaching to reinforce and reward behaviors which build a corporate culture that is in line with HMSA’s vision & mission.

  • Production Management

  • Oversee operational unit.

  • Organize, direct and guide operational staff according to business requirements and objectives.

  • Monitor operational reports for performance fluctuations and trends to effectively manage incoming calls, written correspondence and work inventory.

  • Participate in interdepartmental discussions regarding business initiatives, operational workflows, and process improvements.

  • Operational Effectiveness

  • Participate and support internal or external claims audit activities. Develop and maintain proper controls to ensure operational effectiveness. Implement corrective actions; adjust training and/or workflow procedures as appropriate.

  • Collaborate with management team on the development of unit business plan, resource plan, and budget.

  • Support and participate process improvements, innovation activities, and other corporate events.

  • Represent unit in production support and project meetings.

  • Other Duties/Functions

  • Attend and complete HMSA training and compliance activities as required.

  • Other duties as assigned.

Minimum Qualifications:

  • Bachelor’s (BA) degree and three (3) years of related work experience; or equivalent combination of education and related work experience.

  • One (1) Year of supervisory experience.

  • Excellent verbal and written communication skills.

  • Excellent coaching skills.

  • Good working knowledge of Microsoft Office applications

  • May be required to drive to offsite locations to support unit staff located outside of main office (i.e Kapolei).

EEO/AA/Disability/Vets Employer