Lead Customer Solution Center Service Representative

Job Summary

The Lead Customer Solution Center Service Representative is responsible for the development of a successful and cohesive Call Center unit, with a high level of productivity to achieve the department's overall performance metrics, and to meet and/or exceed member satisfaction. Assist Call Center Supervisors with the supervision of Member Services Representatives by closely monitoring performance, which includes but not limited to: coaching, mentoring, motivating, counseling, etc. to ensure they are providing optimal customer services and meeting and/or exceeding department goals. Responsible for the daily workflow and leading the work of assigned staff.

Duties

Leadership of day to day activities of Member Services Representatives, including but not limited to: Providing direction. Monitoring of staff performance including attendance. Handling all questions/issues raised by staff. Recommending process improvement processes. Preparing and analyzing call center statistical reports. Monitoring/Adjusting of skill-sets for consistency. Ensuring quantity/quality is met for overtime. Handle escalated calls. Back-up to calls as needed. Assist Supervisor to ensure that Representatives provide accurate, timely and quality service to our members/providers. Ensure that all departmental policies, procedures and standards are being met, as well as the organization's mission. Assist Supervisor to ensure that deviations in performance are identified in advance and process changes are made to redirect performance to acceptable levels. Assist Supervisor to ensure that we provide accurate, timely and professionally written, statistical and verbal reports to management for historical, current status and forecasting purposes. Assist Supervisor in reviewing the Representatives overall quality accuracy. Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. (40%)

Trains and motivates staff. Ensures appropriate service standards are developed and maintained. Leads the work of assigned staff; regularly assigns and checks the work of others, providing guidance, training and feedback on performance to department management.  Oversees the daily office workflow, develops and recommends enhancements to process and procedures.   (5%)

Work with training staff to ensure that training practices support staffing and performance standards, takes responsibility for identifying on-going training needs and integrating training and performance expectations as well as work closely with Supervisors to create and/or modify Desk top procedures. (5%)

Work closely with management to review performance and quality standards on an ongoing basis and to assist with development and implementing incentive programs. As well as motivational programs needed to achieve service standards. (10%)

Ensures that front line service personnel are capturing information and providing feedback to Supervisors that will enable L.A. Care to improve its product and internal process. (10%)

Duties Continued

Represents the Department when requested at meetings. Assist Supervisor with meetings and provides necessary feedback when requested. (5%)

Ensure department remains in compliant with HIPAA regulations relating to protected health information (PHI). (10%)

Maintains attendance expectations. (5%)

Perform other duties as assigned. (10%)

Education Required

Education Preferred

Experience

Required:

At least 2 years of customer service experience.

At least 6 months of lead experience in a health plan/ healthcare customer service call center environment.

Preferred:

Experience in working with the disadvantage population, Covered California, and Cal MediConnect.

Skills

Required:
Must have knowledge in direct line of business. 
 
Must know Medical Terminology.

Must have excellent written and verbal communication skills.

Strong analytical, coaching/mentoring skills, team building.
 
Ability to work effectively with diverse team members.
 
Must also have the ability to troubleshoot problem areas and recommend effective alternative solutions to handle irate callers, and provide optimal customer service for internal and external customers.

Must be flexible with time and be able to work overtime including weekends. 

Must be able to multitask and to streamline day to day operations, policies and procedures.

Must have advance PC skills including Excel and Access.

Preferred:
Bilingual in one of LA Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information