Member Services Processing Supervisor
New
G
GDITHealthcare operations
Source API remote eligibility restrictions: United StatesFull-TimeManager
Salary55,003 - 74,415 USD per year
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Job Details
- Experience
- 4 + years of related experience; 3 or more years of relevant experience.
- Required Skills
- ServiceNowHIPAAData entry
Requirements
- High school diploma or equivalent.
- At least 3 years of relevant experience; the job qualifications section lists 4+ years of related experience.
- Experience supervising processing, administrative, customer service, or operations teams in a high-volume environment.
- Knowledge of data entry, documentation review, and workflow management.
- Familiarity with federal program requirements, eligibility standards, regulatory compliance, or similar frameworks.
- Written and verbal communication skills for coaching staff and coordinating with internal and external stakeholders.
- Strong attention to detail and commitment to accuracy and compliance.
- Proficiency with standard operational software, member service tools, and case-handling systems.
- Ability to handle sensitive information securely and professionally.
- Preferred: experience supporting federal health programs or healthcare operations.
- Preferred: experience with intelligent document processing tools, member service portals, or platforms such as ServiceNow or CXone.
Responsibilities
- Lead and supervise staff processing enrollment applications, certifications, transfers, and documentation.
- Oversee work assignments, productivity monitoring, and performance coaching.
- Manage inbound and outbound member communications while handling PII and PHI in accordance with HIPAA and program guidelines.
- Train and mentor staff on policies, tools, systems, and regulatory requirements.
- Review completed work for quality and completeness, identifying trends, gaps, and training needs.
- Interview candidates, provide hiring recommendations, maintain attendance records, and support employee administration.
- Collaborate with Member Services leadership and operational teams to improve processes and streamline workflows.
- Use digital mail centers, self-service portals, and intake/IDP tools to support workflows and resolve issues.
- Escalate complex cases, data irregularities, and regulatory concerns to appropriate stakeholders.
- Track and report processing metrics and support dual-operations or transition activities as required.
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