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.