CSR / UHC C&S Members In Distress Junior Team Lead
Ttec (TeleTech) - HealthCare Solutions
Concord, NC
07.2018 - Current
- Individual & Family Plans Supervisor Escalation Line and Subject Matter Expert.
- Coach 'Members In Distress' Escalation Team on techniques necessary to complete job tasks for our client United HealthCare Community & State/Medicaid and IFP Exchange insurance plans.
- Motivate team to conquer challenges, assist with setting personal daily goals and develop monthly Coaching Action Plans. Communicate with the team through Microsoft Teams or Zoom meetings.
- Process Quality Assurance daily to maintain company policy and procedures.
- Generate reports on business impacts, along with weekly and monthly status reports; including key accomplishments, action plans, issues, quality percentage and attempted case files.
- Maintain teams schedule's and ensure team is adhering to taking breaks and lunches.
- Establish open and professional relationships with team members to achieve quick resolutions for various issues. Earned trust through open, honest communication and reliable follow-through.
- Evaluate employee skills and knowledge regularly, training and mentoring individuals with lagging skills.
- Obtain United HealthCare C&S insurance (Medicaid Managed Care Plans/MCO/PHP/IFP Exchange) member cases, examine all relevant information to assess validity of complaints to determine possible causes, such as call avoidance or lack of knowledge from UHC Member Service Advocates.
- Review claims adjustments with Providers, submit requests to Resolution Analysts and/or assist members with submitting an Appeal, Grievance or other necessary routes for resolution.
- Submit coaching feedbacks with Standard Operating Procedures on UHC Member Service Advocates to their Supervisors to address identified opportunities that could have made the members call successful, reducing repeat callers and helping the Advocate have a better understanding of their resources.
- Investigate, ask probing questions and educate members of their benefit inquiries and complaints quickly. Deliver prompt service to prioritize customer needs and provide additional resources for first call resolution.