Manager Customer Service Operations - Claims, Geisinger Health Plan
Job Summary
Our successful candidate will have managerial experience working with health insurance claims. Manages a Health Plan Claims - Customer Service Team. Performs oversight of achieving metrics, resource allocation, process improvement, coordinating training and ensuring policy development/updates related to claim and enrollment functions. Assists administration in developing the team's annual operating budget, participating in and/or leading interdepartmental workgroups involved in strategic planning, developing and reviewing policies and procedures.
Job Duties
- Participates in development of performance standards for Customer Service teams, evaluates actual performance against standards, and implements action plans for improvement.
- Manages resource allocation in order to realize efficient production.
- Acts as a liaison between all customer service teams and other departments.
- Develops training and policy development goals and provides oversight to ensure the goals and program are aligned with Customer Service operation goals.
- Maintains decision making authority with regard to clients, employers, vendors, regulators, providers and occasional legislators.
- Works closely with the Customer Service Support Team to continually assess the effectiveness of the Quality Assurance program, and makes recommendations for revisions as needed.
- Performs supervisory functions of departmental recruiting, hiring, training, discipline and counseling.
- Performs performance appraisals on direct reports.
- Assists in preparation of annual department budgets.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
*Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years).
#LI-REMOTE
Position Details
Health insurance claims experience required.
Internet requirements:
Employee required to have/supply: Cable modem, (high speed, only - No DSL or Wireless Cellular Service or Satellite Service) The minimum requirement is:
- •25 MBPS UP
- •75 MBPS DOWN
- •<150 ms Ping Required
- •<30ms Jitter Required
Computer must be connected to the internet via Ethernet cable; wifi is not permitted unless a Virtual Private Network (VPN) is used for the wifi connection
Education
High School Diploma or Equivalent (GED)- (Required)Experience
Minimum of 9 years-Relevant experience* (Required)Skills
Builds Relationships; Manages Conflict And CrisisAbout Geisinger
Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.
Our Commitment to Diversity, Equity and Inclusion
Geisinger values who you are, where you are from, and where you are going. We seek out people of various backgrounds and cultures with unique abilities, non-traditional career paths and ambitious aspirations. We are an Affirmative Action, Equal Opportunity Employer. Women and Minorities are encouraged to apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status. Read more about Our Commitment to Inclusive Recruiting.
Our Vision & Values
Everything we do is about making better health easier for our patients, our members, our students, our Geisinger family and our communities.
KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
EXCELLENCE: We treasure colleagues who humbly strive for excellence.
LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
Our Benefits
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.
A place where you can lead a healthy lifestyle and follow your dreams.
Only at Geisinger.
Best employer for healthy lifestyles – National Business Group
Access to 121 state parks