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Intake Care Senior Representative (MN)
Ref No.: 19-04096
Location: Eden Prairie, Minnesota
A global provider of health insurance's Center for Behavioral Health is looking for support in their customer support center. This individual will be the primary point of contact and advocate for customers calling in with questions related to benefits, eligibility, referrals, and non-clinical resources.

This individual facilitates conversations in a warm and empathetic manner as many of the calls are sensitive in nature. Independent problem solving skills are critical to success within the role along with intelligent judgment of assessing the caller's needs. Based upon the call type and requests, Advocates should be able to use communication and listening skills, knowledge of the mental health/substance abuse field and training to effectively address callers needs in an educational manner.

The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services. Within a call an advocate may:
  • Register participants in the intake system and opens case files
  • Educate participants on their benefits based upon individual plan design and other clinical or non-clinical resources available
  • Conduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concerns
  • Provide participants with names and phone numbers of nearest providers
  • Multi-task by maneuvering through various computer programs and screens
As needed an advocate may also:
  • Write authorizations to ensure claims are paid correctly.
  • Provide follow-up calls to participants to ensure correct information is given
  • Send eligibility requests to determine effective coverage dates or to verify correct benefits are loaded
  • Send complaints to initiate grievance process for customers
On all calls an advocate is responsible for:
  • Providing high quality customer service as identified by Advocacy department quality standards
  • Using independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolution
  • Understanding the business needs of the role, while balancing the needs of the customer
  • Taking an educational approach to ensure callers are able to understand the complexities of accessing care
  • Demonstrating a complete awareness and understanding of the responsibilities and workflows of the various departments internally
Required Experience/Skills:
  • Effective listening and organizational skills
  • A demonstrated ability to type effectively; with strong PC skills/word processing experience and ability to learn new computer software systems
  • Previous call center environment experience preferred
  • Bachelor's degree in mental health field or psychology/social work related field REQUIRED (can also include: family communications, health coaching, community/public health or other related major).