Team Lead Member Services
Location: Pearland Administrative Office
Job Type: Full Time
Kelsey-Seybold Clinic. Your Doctors for Life.
Since 1949, Kelsey-Seybold Clinic has served its patients with one goal in mind – combine the expertise of physicians in a variety of medical specialties, with the close personal care of a family doctor. Kelsey-Seybold is Houston’s largest community-based physician group, caring for more than 400,000 patients. With 19 clinic locations, we are growing to meet the health care needs of our diverse patient population. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.
The Team Lead oversees the day-to–day planning of department operations including reviewing and updating phone line queues, employee skillsets and employee schedules to ensure the department consistently meets production standards and quality customer service is delivered. The Team Lead is essential in problem-solving and serves as first level management with team members to resolve customer problems and reports to management on performance, department issues and identifies workflow improvement opportunities.
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
High School Diploma or GED
Associates or Bachelor’s Degree
3-5 years of experience in a call center environment at health plan or a health care organization
Competent working knowledge of health insurance plans including Prescription Drug Benefits
Demonstrated knowledge of CMS Regulations and Texas Department of Insurance Regulations including working knowledge of member complaints, grievance and appeals processing
Ability to utilize reports to make data driven decisions and monitor staff performance
Proficient in conflict resolution, group interaction and team building
Demonstrated ability to work independently and develop creative solutions to ongoing issues
3-5 years Team Lead or Supervisory experience
Previous Experience using a call documentation system and phone auditing systems
Knowledge of Medical Terminology including CPT and ICD9 coding
Demonstrated ability in handling a high case load of complex issues
Competent working knowledge of KelseyCare Advantage benefit plans, contacts and systems
Experience using Microsoft Excel, , Microsoft Word and a variety of software applications
Knowledge and experience with Call Center technologies including Call Routing systems.
Windows bases computer skills
EPIC tapestry experience
Excellent interpersonal, written, oral and presentation skills