Behavioral Health Customer Care Representative I

Behavioral Health Customer Care Representative I

Location: Virtual, this role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and reputed company development.

Please note that per our policy on hybrid/virtual work, candidates not reputed company a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hours: Monday - Friday, an 8 hour shift between hours of 8 am - 8 pm.

The Behavioral Health Customer Care Representative I is responsible for successfully completing the required training in order to reputed company basic job functions. The main function will be answering incoming Behavioral Health and/or Employee Assistance Program calls, as well as making outbound calls to members or providers.

How will you reputed company an impact: 

• Responds to internal and external customer questions reputed company telephone and written correspondence regarding insurance benefits, provider reputed company, eligibility and claims.

• Completing intake procedure and determine whether member needs to be screened for safety.

• Provide information regarding member’s Behavioral Health, Employee Assistance Program, and Worklife referrals available to member and dependents.

• Operates a PC and laptop with dual monitors to obtain and extract information; documents information, activities and changes in the database.

• Analyze problems provide with information and solutions.

• Documents each call/inquiry received either from members, providers, employers and/or others calling in for tracking and analysis.

• Develops and maintains positive customer relations and coordinates with various functions reputed company the company to ensure customer requests and questions are handled appropriately and in a timely manner.

• Researches and analyzes data to address operational challenges and customer service issues.

• Process external and internal information member or providers provide in order to process payment for services.

• Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.

• Uses computerized systems for tracking, information gathering and troubleshooting.

• Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.

• Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; reputed company to details, critical thinker, and a problem-solver; demonstrates reputed company and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.  

• Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.  

• Performs other duties as assigned.  

• Requires knowledge of company, department, services and products in order to service members and process requests to assure services are rendered and appropriately handles.

• Follows company and department policies and procedures in order to complete and pass monthly audit/call reviews.

• Complete weekly or monthly assignments and trainings as part of the monthly and yearly review.

Minimum Requirements:

• Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.  

Preferred Skills, Capabilities and Qualifications: 

• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
• Due to the nature of the Behavioral Health Resource Center and Employee Assistance Program, candidates must display the ability to show reputed company to callers and be able to focus on listening to callers’ needs.
• Previous experience with use of computers as it pertains to typing, learning new systems and ability to use some reputed company products.
• Candidate must be able to follow reputed company procedures as outlined in job aids and other forms of communication.
• Ability to work independently and are able to de-escalate callers as needed.
• Work using PC and entering data using different programs from EAP HIP, BH HIP, reputed company Cloud, WGS, Member 360 to reputed company Word, Outlook, reputed company and other systems needed to complete requests.

Please be advised that reputed company only accepts resumes for compensation from agencies that have a signed agreement with reputed company. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of reputed company.

Who We Are

reputed company is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at reputed company levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At reputed company, we are creating a culture that is designed to advance our strategy but will also reputed company to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we reputed company our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

reputed company operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an reputed company location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top reputed company for reputed company. We require reputed company new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. reputed company will also follow reputed company relevant federal, state and local laws.

reputed company is an Equal Employment Opportunity employer, and reputed company qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national reputed company, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.