Member Services Supervisor jobs in West Virginia

Member Services Supervisor supervises a group of member services representatives that address health plan or HMO member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for researching more complex questions, investigating the cause of the issue, and responding to members on escalated issues. Being a Member Services Supervisor assists with hiring, training, ongoing monitoring and QA, performance evaluations and any corrective actions of member services representatives. Requires a high school diploma or its equivalent. Additionally, Member Services Supervisor typically reports to a manager. The Member Services Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. Thorough knowledge of functional area under supervision. To be a Member Services Supervisor typically requires 3 years experience in the related area as an individual contributor. (Copyright 2024 Salary.com)

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Supervisor Member Services
  • Highmark Inc.
  • UNKNOWN, WV FULL_TIME
  • Company :

    Highmark Inc.

    Job Description :

    JOB SUMMARY


    This job is responsible for supervising member service call center and ensuring timely, professional, and courteous responses to all customer inquiries and complaints, appropriately referring inquiries to other areas as necessary for resolution. Investigate escalated member inquiries. The incumbent may be required to make routine medical approval decisions.

    ESSENTIAL RESPONSIBILITIES

    • Manage the departmental operations and day-to-day functions.
    • Handle escalated calls from members, state agencies, providers and vendors.
    • Coach and counsel employees.
    • Prepare reports for various internal and external areas for trends and statistics.
    • Create and maintain quality and training programs for department.
    • Responsible for on-call emergency contact for nights and weekend support.
    • Other duties as assigned or requested.


    QUALIFICATIONS

    Minimum

    • High School Education or GED
    • 1 year of experience in supervisory position
    • 3 years of experience in customer service and/or health industry environment

    Preferred

    • Bachelor’s degree

    Skills

    None


      SCOPE OF RESPONSIBILITY
      Does this role supervise/manage other employees?

      Yes

      WORK ENVIRONMENT
      Is Travel Required?

      No

      Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

      Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

      As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

      Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

      Pay Range Minimum:

      $50,200.00

      Pay Range Maximum:

      $90,300.00

      Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

      Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

      EEO is The Law

      Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

      We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

      For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

      California Consumer Privacy Act Employees, Contractors, and Applicants Notice

    • 3 Days Ago

    H
    Supervisor Member Services
    • Highmark Inc.
    • Remote Position, WV FULL_TIME
    • Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for supervising member service call center and ensuring timely, professional, and courteous responses to all customer inqu...
    • 3 Days Ago

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    Ops supervisor
    • Republic Services
    • Morgantown, WV FULL_TIME
    • Republic Services is a leader in Environmental Services, partnering with customers to create a more sustainable world. We are Sustainability in Action our promise to be environmentally responsible and...
    • 1 Month Ago

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    Fire Services Supervisor
    • Total Safety U.S., Inc.
    • Parkersburg, WV FULL_TIME
    • Total Safety is looking for a Fire Supervisor to join their safety conscious team! The Fire Supervisor supervises two or more full time employees in an operation that performs customer service in area...
    • 21 Days Ago

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    Outdoor Services Supervisor
    • Pyramid Global Hospitality
    • Roanoke, WV FULL_TIME
    • Outdoor Services Supervisor Hotel/Resort Name Stonewall Resort Posted Date 11 hours ago(11/8/2023 10:19 AM) Location : Company Name Pyramid Global Hospitality Location US-WV-Roanoke Department Recreat...
    • Just Posted

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    Hospital Support Services Supervisor
    • West Virginia Department of Health Facilities
    • West Columbia, WV FULL_TIME
    • If you are looking for an exciting opportunity to contribute to the healthcare industry and make a difference in patients' lives, we encourage you to apply to this position at Lakin State Hospital in ...
    • 6 Days Ago

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    Member Services Supervisor
    • Crunch
    • San Antonio, TX
    • Benefits: Bonus based on performance Employee discounts Free uniforms Opportunity for advancement Training & development...
    • 3/28/2024 12:00:00 AM

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    Member Services Coordinator
    • Tulane University Staff
    • New Orleans, LA
    • The Coordinator of Member Services oversees the operations of the Member Services desk at the Reily Student Recreation C...
    • 3/27/2024 12:00:00 AM

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    Member Service Representative
    • Ymcade
    • Wilmington, NC
    • ** Member Service Representative** **Job Category****:** MEMBER SERVICES **Supervisor****:** Malinda Leonard **Requisiti...
    • 3/27/2024 12:00:00 AM

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    Member Services Supervisor
    • Crunch Fitness
    • Palatine, IL
    • The Crunch Member Services Supervisor (MSS) will assist with the delivery of an amazing Crunch Member Experience, throug...
    • 3/26/2024 12:00:00 AM

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    Member Services Coordinator
    • Curative HR LLC
    • Austin, TX
    • SUMMARY Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health pl...
    • 3/25/2024 12:00:00 AM

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    Retail Member Services Coordinator- NEC Co-op Energy
    • Nueces Electric Cooperative (NEC)
    • Corpus Christi, TX
    • Retail Member Services Coordinator - Corpus Christi, Texas At NEC Co-op Energy, we believe in investing in our employees...
    • 3/25/2024 12:00:00 AM

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    Bilingual Member Services Supervisor
    • Conexon
    • Kansas City, MO
    • Job Type Full-time Description The Member Services Supervisor's role is to assist in overseeing and managing a team of M...
    • 3/24/2024 12:00:00 AM

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    Marketing, Communications and Member Services Coordinator
    • Lafayette Bar Association
    • Lafayette, LA
    • Job Description Job Description The Lafayette Bar Association, a membership organization representing nearly 1,000 attor...
    • 3/24/2024 12:00:00 AM

    West Virginia (/vərˈdʒɪniə/ (listen)) is a state located in the Appalachian region in the Southern United States and is also considered to be a part of the Middle Atlantic States. It is bordered by Pennsylvania to the north, Maryland to the east and northeast, Virginia to the southeast, Kentucky to the southwest, and Ohio to the northwest. West Virginia is the 41st largest state by area, and is ranked 38th in population. The capital and largest city is Charleston. West Virginia became a state following the Wheeling Conventions of 1861, after the American Civil War had begun. Delegates from so...
    Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
    Income Estimation for Member Services Supervisor jobs
    $54,873 to $68,863