Job Description
Job Title: Contact Center Supervisor - US Healthcare TPA
Business Line: Business Operations (BPO)
Onsite: Irving (Texas)
Job Description:
The Contact Center Supervisor will lead and manage a blended team of Contact Center Representatives in a fast-paced US Healthcare Third Party Administrator (TPA) environment. This role is crucial for ensuring the team provides exceptional, compliant, and efficient service to members, providers, and clients. The supervisor will be responsible for day-to-day team management, performance monitoring, training, and mentoring, with a strong focus on maintaining HIPAA compliance, optimizing workflows, and enhancing team productivity. The ideal candidate will possess a deep understanding of US healthcare operations, including enrollments, claims, and benefits administration.
Key Responsibilities:
- Team Leadership & Management:
- Lead, motivate, and manage a blended team (inbound) of Contact Center Representatives.
- Conduct regular one-on-one meetings, performance reviews, and provide constructive feedback to team members.
- Monitor team and individual performance against key metrics (e.g., AHT, FCR, quality scores, adherence, call/interaction volume).
- Develop and implement strategies to improve team performance, efficiency, and member/provider satisfaction.
- Training & Mentoring:
- Onboard, train, and mentor new team members on company policies, procedures, software, and healthcare-specific processes (e.g., enrollment, benefits, claims).
- Conduct ongoing training sessions to address knowledge gaps, introduce new products or policies, and reinforce best practices.
- Act as a subject matter expert and provide real-time support and guidance to representatives handling complex inquiries.
- Operational Oversight:
- Manage daily call queues, interaction volumes, and staffing levels to ensure service level agreements (SLAs) are met.
- Troubleshoot and resolve escalated member and provider issues, demonstrating exceptional problem-solving and de-escalation skills.
- Collaborate with other departments (e.g., Claims, IT, Quality Assurance) to resolve systemic issues and improve cross-functional processes.
- Compliance & Quality Assurance:
- Ensure all team activities and interactions are in strict compliance with HIPAA regulations and other relevant healthcare laws.
- Conduct quality assurance audits of calls and written correspondence to ensure accuracy, professionalism, and adherence to company policies.
- Document and report compliance issues, ensuring timely resolution and corrective action.
- Reporting & Analysis:
- Generate and analyze performance reports to identify trends, opportunities for improvement, and training needs.
- Present performance data and insights into senior management.
Required Qualifications:
- High School Diploma or equivalent (mandatory)
- Associate or bachelor’s degree (preferred)
- Strong command of spoken and written English
- Typing speed of 30–35 WPM with accuracy
Knowledge:
- In-depth knowledge of HIPAA regulations and a demonstrated commitment to protecting protected health information (PHI).
- Strong understanding of US healthcare operations, including but not limited to:
- Health insurance enrollments and eligibility.
- Claims processing and adjudication.
- Benefit plan administration (PPO, HMO, HSA, etc.).
- Provider networks and credentialing.
Preferred Experience:
- 3–5 years of experience in customer service environment, with at least 1 year in a supervisory or team lead role.
- Exposure to CRM tools, claims systems, and platforms like Availity is a plus
- Experience in voice and non-voice (chat/email) communication channels
- Proven experience in the US healthcare industry, specifically within a TPA, health plan, or provider setting.
- Experience managing a blended contact center team (handling both inbound and outbound calls/interactions).
- Prior experience in a leadership role responsible for training and mentoring new employees.
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