Member Services Supervisor supervises the team responsible for providing customer service to healthcare plan members. Explains coverage details, confirms eligibility, verifies claim status, and may resolve billing issues. Being a Member Services Supervisor directs patients to in-network doctors and explains the authorization process for specialized care. Responsible for researching more complex questions, investigating the cause of the issue, and responding to members on escalated issues. Additionally, Member Services Supervisor maintains confidentiality per HIPAA guidelines. May require an associate degree. 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. To be a Member Services Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision.
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