GENERAL SUMMARY
Guides and drives the development and activities of an organized team. Supervises the day-to-day operations. Serves as subject matter expert. Interfaces directly with customers, trains new employees, and resolves customer concerns within a team to meet or exceed customer service requirements. Responsible for all aspects of service.
ESSENTIAL RESPONSIBILITIES
- Supervises an organized team of cross-functional team members to meet or exceed service requirements.
- Independently examines and analyzes the team’s performance against measured service operation goals; demonstrates ownership for overall team results; recommends and leads the implementation of plan(s) of action to improve the team’s service level.
- Drives the team to identify and implement process improvements; encourages ownership of and group participation in the improvement initiatives.
- Identifies training needs within the team; creates a training plan; coordinates and monitors cross-training efforts within the team to ensure members are knowledgeable in all technical areas.
- Trains employees on the team on products, policies and procedures. Orients new employees.
- Serves as product and process expert and resource to team.
- Prepares for and/or conducts customer presentations; manages customer expectations. Leads team meetings; assists team members in improving their facilitation skills.
- Manages staff development and work standards; provides structured coaching and counseling.
- Researches customer information in response to difficult inquiries including, but not limited to, authorization, payments, denials, coordination of benefits, and eligibility; interfaces with customers by telephone, correspondence and/or in person to resolve concerns.
- As required, becomes directly involved with execution of team processes and functions.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- High school degree or equivalent. Bachelor’s degree preferred.
- Significant (6-7 years) experience in managed health or DME is preferred.
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- Previous work experience as a Medical Coder, Medical Assistant , Field Case Manager, UR Nurse or working with durable medical equipment is strongly preferred.
- Expert knowledge of health care and/or related products, medical terminology, diagnosis and procedure coding, and coordination of benefits.
- Ability to maintain production levels and quality goals.
- Ability to train employees on all products and processes.
- Demonstrated leadership and motivation skills.
- Ability to implement service strategies for internal and external customers.
- Excellent organizational, interpersonal, communication and coaching skills.
- Strong analytical and problem solving skills.
- Able to drive change.
- Ability to multi task.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Tucson, AZ, US
Organization: 43007 - First Script Network Services
Schedule: Full-time
Job Posting: 2013-01-30 00:00:00.0
Job ID: 1310409