Team Lead- Member and Provider Service

📋 Description

• • Serve as the primary point of escalation for member and provider service inquiries, ensuring timely and accurate resolution of complex customer issues.
• • Act as a single point of contact for higher-level support requests within Peak Health Member and Provider Service, coordinating with internal departments to align service workflows.
• • Lead training initiatives for new team members, ensuring competency in WVUHS and Peak Health policies, procedures, and service technologies.
• • Monitor and evaluate specialist readiness and performance metrics to ensure team alignment with departmental and corporate goals.
• • Review and assign escalated service requests, identifying recurring issues to develop or update knowledge base content and improve first-contact resolution rates.
• • Provide direct support via phone, chat, and service requests, aiming to resolve 90% of inquiries on first contact with a customer-focused approach.
• • Mentor and guide team members, offering feedback and support to enhance service quality and operational efficiency.
• • Collaborate with team leadership to implement process improvements, update training materials, and ensure consistent application of policies across the team.
• • Maintain appropriate staffing coverage for chat and call queues, including lunchtime shifts, to ensure uninterrupted service delivery.
• • Research and provide accurate information regarding Peak Health policies, forms, and procedures to employees, managers, and providers.
• • Resolve service problems by analyzing issues, exploring alternative solutions, and escalating unresolved matters to supervisors when necessary.
• • Proactively follow up with customers to ensure needs are met and service request status is communicated throughout resolution.
• • Coordinate additional service support activities as assigned by the Service Manager.
• • Utilize CRM, knowledge management, telephony, and chat systems to manage customer interactions and maintain accurate documentation.
• • Maintain high standards of confidentiality when handling sensitive member and provider information.
• • Manage call volume effectively to reduce abandoned calls and improve team performance metrics.
• • Demonstrate strong written and oral communication skills in all customer and internal communications.
• • Work within a metric-driven environment, tracking and contributing to key performance indicators related to service quality and efficiency.
• • Operate in a standard office environment using Microsoft Office Suite, EPIC, Tapestry, and other required computer systems.
• • Sit for extended periods while performing job duties in a remote work setting.