Customer Solutions Expert Lead - Verifications
Posted 2025-08-23
Remote, USA
Full Time
Immediate Start
<h2>Overview</h2>
<p>The incumbent in this position acts as a subject matter expert (SME) in assigned unit, fields questions from staff, is able to provide appropriate issue resolution and escalation when needed, and assigns work/directs workflows for staff. Assists Supervisor/Manager with coaching, on-the-job training, monitoring work, mentoring new associates and driving results. This position may also serve as a back-up in production. Works with other departments to identify areas of opportunity/performance improvement and recommend solutions.</p>
<p> </p>
<p><strong>The shift for this position is Monday-Friday 10:00am – 6:30pm</strong></p>
<h2>Responsibilities</h2>
<p>PRIMARY RESPONSIBILITIES</p>
<ul>
<li>Act as First point of contact for escalated calls and requests</li>
<li>Responsible for the Assignment of work to Associates</li>
<li>Maintain Daily Boards updates-metrics, messages</li>
<li>Monitor and/or complete production, as applicable</li>
<li>Manages payer, provider and patient complaint resolution</li>
<li>Works with supervisors and staff employees to drive efficient call volume activity and management</li>
<li>Work with supervisors to create efficient work plans and daily assignments</li>
<li>Supports cross-functional process improvement efforts</li>
<li>Keeps abreast of technological and industry developments</li>
<li>Must perform other duties as required or assigned</li>
</ul>
<p>SECONDARY RESPONSIBILITIES</p>
<ul>
<li>Promote staff reliability</li>
<li>Encourage frequent communication among all staff members</li>
<li>Must respond to calls/e-mails in a timely manner</li>
<li>Be proficient with entering information into CART system</li>
<li>Projects/spreadsheets – across all operations</li>
<li>Act as a resource for Customer Service Representatives, line staff-research process issues</li>
<li>Monitor sensitive State Reports</li>
<li>Develop and administer operational policy</li>
</ul>
<h2>Qualifications</h2>
<ul>
<li>High School Diploma or the equivalent plus one year of experience in a CareCentrix Operations role</li>
<li>Knowledge of basic spreadsheet, word processing, and data entry with speed and accuracy is required</li>
<li>Has expert knowledge of department systems and processes, CareCentrix business protocols and regulatory knowledge</li>
<li>Ability to lead by example is also required</li>
<li>Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills</li>
<li>Manage multiple tasks, be detail oriented, be responsive, and demonstrate independent thought and critical thinking</li>
<li>Must have strong organizational and interpersonal skills and be able to effectively manage and prioritize multiple tasks, and demonstrate independent thought and critical thinking skills</li>
<li>Must be detail oriented, be responsive, problem-solve difficult situations with internal and external customers and with process and/or systems issues.</li>
</ul>
<p><strong>What we offer:</strong></p>
<ul>
<li>Starting Pay for external hires is $20.00 - $24.00 / hour + Monthly Incentive Bonus Opportunity. The pay range included in this posting reflects future growth / earning potential.</li>
<li>Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.</li>
<li>Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more</li>
<li>Advancement Opportunities, professional skills training, and tuition /exam reimbursement</li>
<li><p>PayActiv - access earned income in between pay checks</p></li>
<li><p>Walgreens Discount - receive up to 25% off eligible items</p></li>
<li>Great culture with a sense of community</li>
</ul>
<p>CareCentrix maintains a drug-free workplace</p>
<p> </p>
<p>#IDCC</p>
<p> </p>
<p>We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.</p>
<p> </p>
<p> </p>
<p><em>CareCentrix accepts applications on an ongoing basis until a candidate is identified.</em></p>
<p>The incumbent in this position acts as a subject matter expert (SME) in assigned unit, fields questions from staff, is able to provide appropriate issue resolution and escalation when needed, and assigns work/directs workflows for staff. Assists Supervisor/Manager with coaching, on-the-job training, monitoring work, mentoring new associates and driving results. This position may also serve as a back-up in production. Works with other departments to identify areas of opportunity/performance improvement and recommend solutions.</p>
<p> </p>
<p><strong>The shift for this position is Monday-Friday 10:00am – 6:30pm</strong></p>
<h2>Responsibilities</h2>
<p>PRIMARY RESPONSIBILITIES</p>
<ul>
<li>Act as First point of contact for escalated calls and requests</li>
<li>Responsible for the Assignment of work to Associates</li>
<li>Maintain Daily Boards updates-metrics, messages</li>
<li>Monitor and/or complete production, as applicable</li>
<li>Manages payer, provider and patient complaint resolution</li>
<li>Works with supervisors and staff employees to drive efficient call volume activity and management</li>
<li>Work with supervisors to create efficient work plans and daily assignments</li>
<li>Supports cross-functional process improvement efforts</li>
<li>Keeps abreast of technological and industry developments</li>
<li>Must perform other duties as required or assigned</li>
</ul>
<p>SECONDARY RESPONSIBILITIES</p>
<ul>
<li>Promote staff reliability</li>
<li>Encourage frequent communication among all staff members</li>
<li>Must respond to calls/e-mails in a timely manner</li>
<li>Be proficient with entering information into CART system</li>
<li>Projects/spreadsheets – across all operations</li>
<li>Act as a resource for Customer Service Representatives, line staff-research process issues</li>
<li>Monitor sensitive State Reports</li>
<li>Develop and administer operational policy</li>
</ul>
<h2>Qualifications</h2>
<ul>
<li>High School Diploma or the equivalent plus one year of experience in a CareCentrix Operations role</li>
<li>Knowledge of basic spreadsheet, word processing, and data entry with speed and accuracy is required</li>
<li>Has expert knowledge of department systems and processes, CareCentrix business protocols and regulatory knowledge</li>
<li>Ability to lead by example is also required</li>
<li>Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills</li>
<li>Manage multiple tasks, be detail oriented, be responsive, and demonstrate independent thought and critical thinking</li>
<li>Must have strong organizational and interpersonal skills and be able to effectively manage and prioritize multiple tasks, and demonstrate independent thought and critical thinking skills</li>
<li>Must be detail oriented, be responsive, problem-solve difficult situations with internal and external customers and with process and/or systems issues.</li>
</ul>
<p><strong>What we offer:</strong></p>
<ul>
<li>Starting Pay for external hires is $20.00 - $24.00 / hour + Monthly Incentive Bonus Opportunity. The pay range included in this posting reflects future growth / earning potential.</li>
<li>Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.</li>
<li>Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more</li>
<li>Advancement Opportunities, professional skills training, and tuition /exam reimbursement</li>
<li><p>PayActiv - access earned income in between pay checks</p></li>
<li><p>Walgreens Discount - receive up to 25% off eligible items</p></li>
<li>Great culture with a sense of community</li>
</ul>
<p>CareCentrix maintains a drug-free workplace</p>
<p> </p>
<p>#IDCC</p>
<p> </p>
<p>We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.</p>
<p> </p>
<p> </p>
<p><em>CareCentrix accepts applications on an ongoing basis until a candidate is identified.</em></p>