Excellus BlueCross BlueShield Operations Unit Coordinator I/II in Utica, New York
The Operations Coordinator is viewed as a user expert in a specified operations unit. This position is responsible for coordinating the daily production of assigned unit, including but not limited to Membership & Billing, Claims, Customer Service and/or Reconciliation departments. Individuals in this position are responsible for organizing “the work” of varying scope and complexity as it relates to the unit. All incumbents will possess an in-depth understanding of the work, systems, and processes as it pertains to their assigned unit. They will provide solutions and direction to staff to free their unit of inconsistencies while creating a consistent customer experience.
• Accountable for accuracy and timeliness of own work.
• Actively assists, coaches, and mentors team members to meet/exceed overall department monthly targets/quotas/goals.
• Prioritizes work and provides coaching, instruction, advice, and guidance to more junior staff as it relates to the assigned unit processes, procedures, and business systems.
• Controls and monitors inventory levels of assigned department according to established priorities and performance standards.
• Resolves complex issues that involve multiple processes and collaborates with others outside of the assigned functional area.
• Monitors and evaluates workflow to ensure timeliness and department standards are met. Provides reporting, analysis and recommendations to unit management.
• Coordinates to ensure consistent policy, procedures, and customer experience across regions.
• Collaborates with junior level staff and is a positive influence within a team structure.
• Identifies, tracks, and trends unit related issues and questions. Assess staff training needs and provides recommendations for improvement and retraining. Provides feedback to Leadership regarding department and individual staff performance.
• Identify and conducts ongoing staff training regarding updated policies and procedures regulations, product changes, etc.
• Provides support to the supervisor for the development and maintenance of routine reports.
• Collaborates with Analysts regarding changes in processes/systems, identifies problems, and recommends logical and effective solutions.
• Understands performance of team activities; ability to identify problem areas of the unit, devise solutions to enhance quality of service and to prevent future problems or repeat issues.
• Facilitates adherence to unit Service Level (SLA) and Operational Level Agreements (OLA), monthly metrics reporting and other operational commitments.
• Ensures that work is accurately and efficiently processed while providing service to customers.
• Conducts team meetings and discussions resulting in a productive outcome.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and Leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by Leadership.
• Provides coverage for other Coordinators in a function unrelated to their assigned team to ensure sufficient backup. Works with areas outside the immediate team to resolve inventory issues.
• Seeks internal or external opportunities to enhance personal skill set and capabilities.
• Competent to flex within role across work units or multiple lines of business on a consistent basis.
• Understands and is able to verify validated concepts in order to determine the most appropriate course of action for complex customer issues, complaints, claims, etc.
In addition to Level I responsibilities:
• Represents Department Leadership at meetings.
• Completes a root cause analysis on issues going beyond the individual issue correction to global resolution.
• Prepares, monitors, and presents key reports. Understands the data and has the ability to take corrective action with management support.
• Actively participates and makes recommendation regarding the development and maintenance of functional procedures and instructional manuals; conducts informational meetings with the team.
• Provide cross functional support with ability to assist among multiple specialty areas within operational excellence.
• Effectively engage in special projects across internal business partner areas.
• Call Center Specific: Primarily focused to supporting Call Center team real time on phones.
• Claims Specific: Must be able to flex between supporting claim processing and adjustments or support both Local and National claim teams.
• Enrollment Specific: Must be knowledgeable in all processes in the specific line of business they support.
Note of Classification: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.
• Seasoned professional with in-depth understanding of the assigned business department’s functions, processes, and systems.
• AAS degree and two years related work experience as it pertains to the assigned operations business unit. In lieu of degree three years of experience in related area.
• Able to work on multiple issues, customer issues, and unit projects simultaneously.
• Must have unit specific knowledge of business systems and Health Plan operations.
• Gains trust quickly of other parties in negotiations.
• Superior and diplomatic communication skills including oral, written, and listening.
• Demonstrated ability to learn and provide guidance to junior level staff.
• Demonstrates independent decision making skills and handles confidential information with discretion.
• Strong customer focus.
• Strong listening, organizational, reasoning, and creative problem solving skills.
• Self-motivated, performance accountability.
• Is recognized as a subject matter expert by team.
• Demonstrates an attitude that promotes team spirit and team involvement.
• Must possess the skill and aptitude to provide effective in person, written, and phone coaching/education.
• Diplomatic. Understands the organizational culture.
• Ability to multitask with detail retention, high level of specificity in tasks.
• Ability to manage assignments from inception to completion successfully.
• Demonstrates role-specific competencies as it pertains to their department on a consistent basis.
In addition to Level I:
• Demonstrated broad understanding of multiple business units OR demonstrated in-depth knowledge of multiple functions, processes and/or systems within a unit.
• Must have at least one year prior experience in a leadership role.
• Travel may be required may be required including but not limited to other regions, provider offices, or other locations.
• Work is completed in a normal office environment under fluorescent lighting.
• Ability to use a headset to listen to customer conversations required.
• Must be able to function while sitting at a desk viewing a computer and using a keyboard and mouse for 3 or more hours at a time.
• In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.
Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.
OUR COMPANY CULTURE:
Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.