Claim Processing Operation Manager

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 nota...