Customer Service Lead Representative

وصف الوظيفة

About the Role The Customer Service Lead Representative plays a critical role in supporting the delivery of exceptional customer service across member, provider, client, and broker interactions while providing day-to-day operational support within the contact centre. This role serves as a senior technical and operational resource, managing complex enquiries, complaints, escalations, and service recovery activities while helping ensure service continuity, workload visibility, and adherence to service standards. Working closely with the Customer Service Manager, the Customer Service Lead Representative provides floor support, operational guidance, and knowledge sharing to Customer Service Representatives, helping to drive service quality and operational effectiveness. This is not a formal people management role and does not include employee performance management, disciplinary authority, or approval responsibilities. What You'll Do Investigate and resolve complex customer enquiries, complaints, appeals, and escalated service issues across calls, emails, and written correspondence. Act as the primary operational and technical escalation point for cases requiring advanced research, coordination, policy interpretation, or procedural guidance. Interpret policy provisions, benefits, procedures, and operational requirements to determine appropriate solutions and escalation pathways. Maintain end-to-end ownership of escalated cases, ensuring timely resolution, accurate documentation, proactive follow-up, and clear customer communication. Support service recovery activities by managing customer expectations, coordinating corrective actions, and ensuring customer concerns are effectively addressed. Collaborate with Health Plans, Claims, Approvals, Service Centres, Providers, IT, and other stakeholders to facilitate prompt resolution of customer issues. Build effective working relationships with internal and external stakeholders while supporting a seamless customer experience. Monitor service queues, pending inventories, backlogs, ageing cases, and service-level risks, escalating concerns appropriately to the Customer Service Supervisor. Support workload coordination and operational prioritisation based on customer impact, service commitments, and business requirements. Ensure effective shift handovers through accurate communication of priority cases, unresolved issues, and operational updates. Assist with the preparation of operational updates, service-level reports, escalation summaries, workload status reports, and risk visibility reporting. Identify recurring service issues, root causes, process gaps, and customer experience challenges, providing recommendations for improvement. Contribute to knowledge-sharing initiatives, onboarding activities, refresher training sessions, process enhancements, and quality improvement programmes. Support quality assurance reviews, compliance activities, audits, and operational governance requirements. Maintain accurate customer records and ensure all activities comply with company policies, regulatory requirements, confidentiality obligations, information security standards, and data privacy requirements. Continue supporting core customer service activities during periods of high contact volumes, operational peaks, and business-critical events. Provide designated operational support coverage during the absence of the Customer Service Manager while remaining within the role's defined authority limits. What You'll Bring Diploma or Bachelor's degree, preferably in Business Administration, Healthcare Administration, Customer Service Management, or a related discipline. Minimum of 3 to 5 years of experience in customer service, member services, client services, call centre/contact centre operations, or a related customer support environment. Demonstrated experience managing complex customer enquiries, complaints, escalations, and service recovery situations. Experience within the healthcare insurance industry is strongly preferred; experience within insurance, managed care, banking, financial services, or third-party administration environments will also be considered. Strong understanding of contact centre operations, service levels, escalation management, workload prioritisation, case ownership, and queue management principles. Proven ability to work independently, manage competing priorities, and maintain service quality under pressure. Fluency in written and spoken Arabic and English. Willingness to work flexible shifts in line with business requirements. Skills Soft Skills Strong communication skills with the ability to engage professionally and empathetically with customers and stakeholders. Customer-focused mindset with sound judgement and professionalism in sensitive or challenging situations. Strong problem-solving and analytical capabilities with the ability to make decisions within established guidelines. Excellent organisational, prioritisation, and time-management skills. Ability to guide, coach, and influence colleagues through expertise and collaboration rather than formal authority. Strong stakeholder management and relationship-building skills. High levels of accountability, ownership, and attention to detail. Ability to adapt to changing priorities, operational demands, and business needs. Technical / Functional Skills Strong knowledge of customer service operations, escalation management, complaint resolution, and service recovery principles. Ability to accurately interpret insurance policies, customer benefits, procedures, and operational requirements. Understanding of contact centre performance metrics, including service levels, turnaround times, quality scores, response times, customer satisfaction, and productivity measures. Experience monitoring queues, workloads, pending inventories, backlogs, and operational performance risks. Ability to identify trends, root causes, operational gaps, and opportunities for continuous improvement. Intermediate to advanced Microsoft Office skills, particularly Excel, Outlook, and PowerPoint. Experience using CRM systems, customer service platforms, and case management tools. Strong multitasking capability within a fast-paced, high-volume operational environment. Ability to maintain accurate case records, escalation logs, operational updates, and customer interaction documentation. What You'll Bring Diploma or Bachelor's degree, preferably in Business Administration, Healthcare Administration, Customer Service Management, or a related discipline. Minimum of 3 to 5 years of experience in customer service, member services, client services, call centre/contact centre operations, or a related customer support environment. Demonstrated experience managing complex customer enquiries, complaints, escalations, and service recovery situations. Experience within the healthcare insurance industry is strongly preferred; experience within insurance, managed care, banking, financial services, or third-party administration environments will also be considered. Strong understanding of contact centre operations, service levels, escalation management, workload prioritisation, case ownership, and queue management principles. Proven ability to work independently, manage competing priorities, and maintain service quality under pressure. Fluency in written and spoken Arabic and English. Willingness to work flexible shifts in line with business requirements. Skills Soft Skills Strong communication skills with the ability to engage professionally and empathetically with customers and stakeholders. Customer-focused mindset with sound judgement and professionalism in sensitive or challenging situations. Strong problem-solving and analytical capabilities with the ability to make decisions within established guidelines. Excellent organisational, prioritisation, and time-management skills. Ability to guide, coach, and influence colleagues through expertise and collaboration rather than formal authority. Strong stakeholder management and relationship-building skills. High levels of accountability, ownership, and attention to detail. Ability to adapt to changing priorities, operational demands, and business needs. Technical / Functional Skills Strong knowledge of customer service operations, escalation management, complaint resolution, and service recovery principles. Ability to accurately interpret insurance policies, customer benefits, procedures, and operational requirements. Understanding of contact centre performance metrics, including service levels, turnaround times, quality scores, response times, customer satisfaction, and productivity measures. Experience monitoring queues, workloads, pending inventories, backlogs, and operational performance risks. Ability to identify trends, root causes, operational gaps, and opportunities for continuous improvement. Intermediate to advanced Microsoft Office skills, particularly Excel, Outlook, and PowerPoint. Experience using CRM systems, customer service platforms, and case management tools. Strong multitasking capability within a fast-paced, high-volume operational environment. Ability to maintain accurate case records, escalation logs, operational updates, and customer interaction documentation. Nice to Have Knowledge of healthcare insurance operations, medical terminology, and healthcare service delivery models. Experience supporting onboarding, floor support, knowledge-sharing, quality calibration, or process improvement initiatives. Experience preparing service-level reports, operational dashboards, workload updates, or escalation reporting. Familiarity with complaint management frameworks, quality improvement methodologies, and continuous improvement practices.