Resolve unpaid/denied claims by leveraging propriety software system, making phone calls, generating letters, accessing client systems and insurance carrier web portals in the pursuit of getting a claim resolved.Review medical documentation such as UB04 claim forms, EOB’s and medical records to determine the appropriate course of action for claim resolution.Maintain familiarity with client preferences and known issuesMeet monthly production and quality expectations.Comply with HIPAA privacy laws & other duties assigned.

Supervise staff and operations of Customer Service Contact Center Team/DepartmentAccountable for providing effective supervision of assigned staff to ensure efficient and cost-effective operationCustomarily and regularly directs work of 40+ employeesMake decision or recommendations concerning hiring, firing, advancement, promotion or other changes of employee's statusProvide effective supervision, leadership, guidance motivation to staff to ensure that all goals and objectives are metReceives and responds promptly and accurately to all customer inquiries and complaint via telephone that have escalated to Supervisory levelEnsure adherence to customers experience and departments quality and compliance guidelines through regular side by sides, observed listening, and floor presenceEnsure that staff has necessary information, knowledge, and training to efficiently perform all job responsibilitiesMonitor and assess staff performance and administer feedback daily, monthly and yearlyMonitor, review and provide regular feedback to staff on quality and quantity of work producedCoaches and trains specialists consistently in areas such as communicating prompt service options to customers, taking inbound call questions as well as outbound calls for follow up, completion of needed and accurate information in courteous and professional manner to customersProvide ongoing guidance, feedback, and motivation to staff to ensure exceptional performance and maximum utilization of resourcesReview TO requests and timesheets for approval/denialReview and administer quality and compliance checks as required by department on daily basis including administering regular monthly scorecard assessments and PDA as neededEnsure all necessary measured scored for agents are input on monthly basisTrained new agent/s as well as tenure agents in customer service call quality and call handlingInteracted with agents using email/chat ticketing system Zendesk and Teams