Team Lead – Member and Provider Service

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as an escalation point for calls from member and provider service managers.

• Serve as the primary contact for advanced support inquiries for Peak Health.

• Engage in meetings with various Peak Health departments to remain informed about actions impacting Customer Service and Insurance workflows.

• Mentor new team members and ensure their understanding of the policies and procedures pertinent to their roles.

• Oversee the progress towards specialist readiness.

• Lead training initiatives and ensure all materials are updated accordingly.

• Work collaboratively with team leadership to align departmental and corporate goals through training and process management.

• Regularly assess escalated service requests for proper assignment, identifying activities that can develop into Customer Service knowledge areas.

• Ensure adequate coverage for chat inquiries and call handling during lunch breaks.

• Address chats, calls, and service requests from employees and managers promptly, focusing on resolving 90% of inquiries on the first contact.

• Offer insights and advice to managers and employees regarding Peak Health policies, procedures, forms, and processes.

• Clarify inquiries by providing detailed information; research, locate, and deliver the necessary information.

• Resolve issues by clarifying problems; research and investigate solutions, and escalate unresolved issues to a supervisor.

• Anticipate and respond to customer needs, following up until all needs are satisfied. Maintain proactive communication with customers to keep them informed about the status of service requests until resolution.

• Coordinate additional service support tasks as assigned by the manager.

⛳️ Requirements

• High school diploma or equivalent AND five (5) years of experience in customer service support OR an Associate degree AND three (3) years of experience in customer service support OR a Bachelor’s degree AND two (2) years of experience in customer service support.

• Three (3) years of experience in a call center service environment.

• Two (2) years of experience with service technologies, including telephony, chat, CRM management, knowledge management, training, and documentation.

• Two (2) years of experience in a health insurance or medical environment.

• Bachelor’s Degree or higher in a related healthcare field (preferred).

• One (1) year of experience with Peak Health Member and Provider Service (preferred).

• Five (5) years of service experience, preferably in a call center environment (preferred).

• Three (3) to (5) years of experience in health insurance (preferred).

• Three (3) years of experience with commercial, Medicare, and Medicaid plans (preferred).

• Three (3) years of experience working in a metric-driven environment (preferred).

🏝️ Benefits

• Health insurance

• 401(k) matching

• Professional development opportunities