Claim Processing Operation Manager

Job Code : REQ-013619
El Paso Adabel Partially Remote/Hybrid

Job Description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Claim Processing Operation Manager

Job Description:

We are currently hiring a talented Operations Manager to contribute to the overall client satisfaction, retention and account profitability objectives by ensuring the operational performance standards for assigned accounts are met and enhanced.

Education:

High School Diploma or equivalent required. BA/BS in Business Administration or related field or equivalent preferred but not necessary.

Experience:

4+ years experience in customer service, call center or related field, including 3 years in management.  Healthcare Industry Preferred

Mandatory Skills:

  • Exceptional interpersonal, customer service, problem-solving, verbal and written communication, and conflict resolution skills.

  • Proficiency with the necessary technology, including computers, software applications, phone systems, etc.

  • Ability to improve and/or transform teams processes across functions within the organization.

  • Ability to drive individual, teams and department efficiency and productivity through effective and efficient metric management.

  • Strong coaching and leadership skills, ability to develop and motivate employees towards improved performance.

  • Ability to delegate and manage work loads and projects across functions within the organization.

  • Ability to successfully drive continuous improvement efforts by leading various work streams related to call center metrics and monitoring tools.

  • Capacity to operate in a complex, global environment with ease and fluidity, while driving and influencing results.

  • Strong operational and financial acumen, executive presence, and the ability to lead multiple sites.

  • Ability to problem solve, handle conflict, anticipate issues/concerns, troubleshoot problems, and proactively institute creative solutions.

  • Advanced customer focus and customer service skills.

  • Ability to multitask and remain calm under pressure, especially during peak hours or intense situations.

  • Ability to handle reporting, financial analysis (cost-effectiveness, cost-benefit etc.) & budgeting.

Roles & Responsibilities:

  • Provides day-to-day leadership, coaching and development to Supervisors, Sr. Supervisors or Assistant Managers.

  • Review operating statistics regularly to ensure Client and Organization goals are being met in areas of service quality and timeliness. Typical areas of focus include: quality monitoring scores, customer satisfaction, account notations, call handle times, abandon rates and service levels. 

  • Identify areas of process improvement and work effectively within the organization to implement resolutions on a timely basis.  Areas for improvement should be targeted at increasing client satisfaction and/or company profitability. 

  • Oversee and/or delegate necessary enhancements to client programs or servicing therein.  This may include areas such as staffing, training, attendance and quality.

  • Work closely with Account Management to deliver critical client communication and provide information for performance review meetings.

  • Work with Workforce Management to optimize staffing to achieve proper balancing of client servicing objectives and company profitability. 

  • Responsible for service quality for all work performed by his/ her employees. 

  • Ensure accountability through the front line employees are being delivered daily, weekly, and monthly.

  • Participate and lead client visits and roundtables to provide input on program performance or new programs being offered.

  • Coordinate with the Leadership team to balance needs of individual team with needs of the entire organization.

  • Provide growth development opportunities.

  • Promote teamwork and cooperative effort.  Help train and provide guidance to other employees within the organization.

  • Maintain a clean, safe, and unobstructed work area, and practice good safety habits.

  • Ensure both internal and external customers are provided with the highest quality service

Salary Range: $65,000.00 and up dependent on experience and location

Sagility Offers Competitive Benefits Including:

  • Medical

  • Dental

  • Vision

  • Life Insurance

  • Short-Term and Long-Term Disability

  • Flexible Spending Account

  • Life Assistance Program

  • 401K with employer contribution

  • PTO and Sick Time

  • Tuition Reimbursement

Join our team, we look forward to talking with you!

An Equal Opportunity Employer/Vet/Disability

Location:

El PasoUnited States of America