Let’s do great things, together
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.
Currently, Moda Health is seeking a Manager in our Medical Customer Service department. The Manager develops and maintains policies, procedures and guidelines for the customer service department; ensures prompt, efficient, and accurate information is provided to customers and policyholders; works closely with the Supervisors to ensure consistency of processes and procedures; responsible for staff organization, setting goals, coaching, motivating and development of staff.
1. Plans, organizes and directs workflow of the department in order to ensure that quality and quantity goals are reasonable and met by staff.
2. Assesses and oversees process improvement implementation plans to ensure departmental processes are efficient. Once process improvement endeavor is implemented, evaluate and modify as is appropriate.
3. Ensures prompt, efficient, and accurate customer service administration by developing and implementing appropriate goals with Director.
4. Prepare monthly, quarterly and annual statistical reports.
5. Continually reviews and recommends workflow and processing enhancements, working closely with supervisors to ensure processing consistency.
6. Provides direction to supervisors and keeps them informed of expectations and performance on a monthly basis.
7. Recommends appropriate staffing requirements based on projected new sales and retention of business.
8. Ensures departmental quality assurance standards are adhered. Reviews performance issues with supervisors and takes appropriate disciplinary action when appropriate.
9. Provides direction to supervisors and keeps them informed of expectations and performance on a monthly basis.
10. Participate in or manage projects as assigned.
11. Contributes to and supports the corporation’s quality initiatives by encouraging team and individual contributions toward the corporation’s quality improvement efforts.
12. Personnel administration including timekeeping, performance appraisals, interviewing, hiring, counseling, etc.
13. Other special projects as requested by Director.
Are you ready to be a betterist?
If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.
1. Bachelor degree or equivalent work experience specializing in business administration, customer service and/or health insurance.
2. A minimum of 4 years supervisory experience in claims and/or customer service.
3. Ability to motivate and direct staff in order to meet customer service standards.
4. Demonstrated strong, effective and diplomatic interpersonal skills with employees of all levels.
5. Demonstrated ability to identify training and/or retraining needs of staff.
6. Demonstrated knowledge of Microsoft Office applications.
7. Excellent reading, oral, and written communication skills and ability to interact professionally, patiently, and courteously with internal and external customers.
8. Strong problem solving and decision making skills.
9. Ability to work well under pressure in a complex and rapidly changing environment.
10. Maintain confidentiality and project a professional business presence and appearance.
11. Knowledge and understanding of Moda contract and administrative policies affecting claims would be helpful.
12. Demonstrated consistent ability to comply with company rules and policies.
13. Maintain attendance above company standards.