Call Center Investigation Lead

Call Center Investigation Lead

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple – we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external – driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

JOB SUMMARY

In addition to managing a substantial (50%) workload, the incumbent will partner with leadership colleagues to assure that the team meets its performance metrics, quality performance, and business objectives. The duties require an advanced knowledge of the Investigations and all related processes. 

DUTIES

1. Monitor call volumes and agent statuses while ensuring excellent customer service. Manage a moderate volume of inbound calls in a timely manner.
   2. Answer questions from the agents regarding call procedures and best practices.
   3. Answer and mitigate escalation calls to reduce risk of abrasion.
   4. Monitor and coach agents on their soft skills.
   5. Report and monitor technical issues experienced by the agents to ensure efficiency.
   6. Record detailed and accurate case information obtained from calls or written correspondence.
   7. Research and request case information to develop cases. Access and acquire benefit information from clients’ remote health claim systems.
   8. Maintain department productivity and quality standards.
   9. Follow client specific procedures and guidelines.
   10. Collaborate, coordinate, and communicate across disciplines and departments.
   11. Ensure compliance with HIPAA regulations and requirements.
   12. Demonstrate Company’s Core Competencies and values held within.
   13. Please note due to the exposure of PHI sensitive data — this role is considered to be a High Risk Role.
   14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE 

This role works under limited supervision in the execution of the roles’ day-to-day responsibilities. Tasks completed within this role will fall within a defined set of duties and responsibilities.

COMPENSATION

The salary range for this position is $21.50 per hour. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

Qualifications

REQUIREMENTS

* Minimum high school diploma and two (2) years of work experience in health insurance and/or call center environments. Associates degree in a relevant discipline is strongly preferred..
* Required licensures, professional certifications, and/or Board certifications as applicable.
* Strong communication and client interfacing skills
* Ability to diffuse escalated calls and remain calm under pressure
* Strong organizational and time management skills
* Ability to work independently and as part of a team
* Ability to troubleshoot issues with team members and seek the assistance of Management if needed.
* Conduct themselves in a professional and courteous manner with all team members.
* Good organizational, analytical and independent decision-making skills
* Strong problem-solving skills with the ability to manage multiple priorities and meet associated timelines
* Good written and oral communication skills to interact with all levels within the organization
* Working knowledge of Microsoft Word, Excel, internet research skills
* Minimum 50 WPM typing
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone.

BENEFITS

We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.

Your benefits will include:

• Medical, dental and vision coverage with low deductible & copay
• Life insurance
• Short and long-term disability
• Paid Parental Leave
• 401(k) + match
• Employee Stock Purchase Plan
• Generous Paid Time Off – accrued based on years of service
  • WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
• 10 paid company holidays
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits

EEO STATEMENT

Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here.

APPLICATION DEADLINE

We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.

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