Manager, Customer Service
Apply NowCompany: Harris Health System
Location: Houston, TX 77084
Description:
About Us
Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
Job Profile
JOB SUMMARY: The Manager of Customer Service serves Providers by maintaining departmental operations to include management of incoming calls related to claims payments, eligibility verification, as well as benefit interpretations; improving systems and processes; supports overall performance in meeting the state and federal guidelines and regulations; working with all levels of Leadership; developing and ensuring necessary staff education, and scripting the optimization of existing programs; defining service level targets for speed, efficiency, courtesy, and quality; managing staff to achieve service level targets and goals; and promoting culture that encourages and ensures Provider & Provider Call Center staff satisfaction.
MINIMUM QUALIFICATIONS:
Education/Specialized Training/Licensure:
Work Experience (Years and Area):
Management Experience (Years and Area):
Equipment Operated: General office equipment
SPECIAL REQUIREMENTS:
Communication Skills:
Other Skills:
Advanced Education: Bachelor's Degree Major: BS/.BA (preferred)
Other Requirements:
RESPONSIBLE TO: Director
EMPLOYEES SUPERVISED:
Benefits and EEOC
Community employees' benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.
Community is an Equal Opportunity Employer.
Harris Health System's benefits program is designed to provide you with more flexibility and choices in meeting your specific needs. Harris Health System's benefits program allows you to protect your income in case of illness, death and disability, and to help you save for retirement.
It is the policy of Harris Health System to provide equal opportunity for all applicants for employment regardless of political affiliation, race, color, national origin, age, sex, religious creed or disability. Applicants may request any reasonable accommodation(s) to participate in the application process.
Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
Job Profile
JOB SUMMARY: The Manager of Customer Service serves Providers by maintaining departmental operations to include management of incoming calls related to claims payments, eligibility verification, as well as benefit interpretations; improving systems and processes; supports overall performance in meeting the state and federal guidelines and regulations; working with all levels of Leadership; developing and ensuring necessary staff education, and scripting the optimization of existing programs; defining service level targets for speed, efficiency, courtesy, and quality; managing staff to achieve service level targets and goals; and promoting culture that encourages and ensures Provider & Provider Call Center staff satisfaction.
MINIMUM QUALIFICATIONS:
Education/Specialized Training/Licensure:
- BS or BA degree or four years of experience in lieu of degree
Work Experience (Years and Area):
- 5 years in Health care, Quality monitoring, customer service, healthcare, preferable Managed Care
Management Experience (Years and Area):
- Four or more years supervisor/lead experience
Equipment Operated: General office equipment
SPECIAL REQUIREMENTS:
Communication Skills:
- Above Average Verbal (Heavy Public Contact)
- Writing /Composing Reports
Other Skills:
- CRT Medical Terms
- P.C. MS Word MS Excel
Advanced Education: Bachelor's Degree Major: BS/.BA (preferred)
Other Requirements:
- Familiarity with medical coding and general claims payment rules and member cost-sharing.
- Strong customer service skills required.
- Experience with telephone queue management
RESPONSIBLE TO: Director
EMPLOYEES SUPERVISED:
- Clerical Service
- Supervisory
Benefits and EEOC
Community employees' benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.
Community is an Equal Opportunity Employer.
Harris Health System's benefits program is designed to provide you with more flexibility and choices in meeting your specific needs. Harris Health System's benefits program allows you to protect your income in case of illness, death and disability, and to help you save for retirement.
It is the policy of Harris Health System to provide equal opportunity for all applicants for employment regardless of political affiliation, race, color, national origin, age, sex, religious creed or disability. Applicants may request any reasonable accommodation(s) to participate in the application process.