Supervisor, Customer Service

About the role

Brighton Health Plan Solutions (BHPS) is seeking an experienced Customer Service Supervisor to manage the company’s service operations for members and providers in a high-traffic call center. The Supervisor directly oversees the daily performance and activities of Customer and/or Provider Service call center representatives to ensure customer satisfaction and achievement of the department’s KPIs. The role involves reviewing call traffic reports and adjusting staffing levels to meet business needs.

Responsibilities

• Handle inbound calls from physicians, hospitals, and other medical provider representatives.
• Support and mentor Team Leaders and Subject Matter Experts (SMEs) as needed.
• Resolve caller escalations as needed.
• Monitor team call center metrics, quality assurance scores, and productivity reports.
• Assist the Customer Service Manager with performance reports, QA review sessions, and re-training initiatives.
• Manage departmental call activity and ensure appropriate staffing levels and scheduling to meet KPIs.
• Answer and handle call center calls when needed to ensure KPI levels are met.
• Conduct quality call monitoring review sessions with the Customer Service Manager to coach performance and identify training needs.
• Provide support to customer service representatives as needed.
• Manage special projects and allocate resources as required.
• Collaborate with Network Management, Account Managers, and Sales teams to gather feedback and enhance service performance.
• Conduct impact analysis of changes to service team operations, ensuring internal customers are consulted and informed prior to implementation.
• Participate in activities designed to improve customer satisfaction and business performance.
• Work with the Customer Service Manager and Director to identify call reduction efforts and execute strategies accordingly.
• Support projects and other departments in completing tasks when directed by management.

Requirements

• Experience in a high-volume call center, including claims inquiry and review procedures.
• Knowledge of medical specialties, fee schedules, complaints and appeals, and call center responsibilities.
• Previous experience in a physician’s office, group practice, clinic, or hospital-based practices.
• General knowledge of medical terminology and HIPAA confidentiality laws.
• High school diploma or GED required; Bachelor’s degree preferred but not required.
• Prior experience managing teams in a customer call center.
• Experience managing call center volume using ACD systems.
• Experience in quality call monitoring, performance coaching, counseling, and progressive discipline.
• Proficiency in healthcare transactions systems, CRMs, quality call tools, and monitoring systems.
• Ability to create staffing schedules and analyze call center volume and trends.
• Knowledge of basic computer operations and intermediate knowledge of Microsoft Office (Word, Excel, Access, PowerPoint, Outlook).
• Strong time management skills.
• Knowledge of CPT codes and ICD-9.
• Ability to learn quickly.
• Knowledge of managed care procedures and claims payment policies.
• Courteous with a strong customer service orientation.
• Previous multi-channel experience (voice, email, and chat) is a plus.

About the company

At Brighton Health Plan Solutions, LLC, our people are committed to improving how healthcare is accessed and delivered. We foster a diverse and welcoming culture focused on encouragement, respect, and increasing diversity, inclusion, and a sense of belonging at every level. Employees are encouraged to bring their authentic selves to work with all their unique abilities.

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers, and other TPAs to solve today’s healthcare challenges with flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, proprietary provider networks, and an innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with customizable tools to enhance the member experience, improve health outcomes, and achieve their healthcare goals.