CUSTOMER SERVICE REP II - Part Time in Kapolei, HI at Beacon Health Options

Date Posted: 7/18/2018

Job Snapshot

Job Description

We are currently seeking a dynamic PT CUSTOMER SERVICE REPRESENTATIVE to join our team at our office in Kapolei. The Customer Service Representative is the front line interface to members and providers with behavioral health needs. The Customer Service Representative assists callers by providing benefit and eligibility information and referrals to network providers. The Customer Service Representative transfers clinical calls to clinicians, as defined in the transfer protocol, in addition to being responsible for completing specified assignments that assist the department in meeting contractual goals.

Position Responsibilities:

  • Staff all Member Service ACD queues and adhere to telephone performance requirements for call response times and abandonment rates.

  • Respond to member requests to access behavioral health services and for referrals to network providers.

  • Determine which calls need to be transferred to a clinician, as defined by established protocols, including emergency call procedures.

  • Verify members’ health Insurance coverage, when necessary.

  • Prepare daily correspondence for mailing including prior authorization determination, member and provider educational material, etc.

  • Perform data entry of specified authorization requests or other data entry and reporting as needed.

  • Outreach to new members that have been identified with behavioral health needs.

  • Other duties as assigned, including but not limited to:

    • Participation in Quality Improvement Teams and/or projects

    • Back up coverage for Aftercare Coordinator

    • Office Supplies Coordinator

    • Assist in training of new staff

  • Documents all call information according to standard operating procedures.

  • Checks personal voice mail and return calls within 1 business day.

  • Follows health plan specific contract guidelines.

  • Attends all department and general staff meetings.

  • Forwards patient and provider complaints per health plan guidelines.

  • Adheres to all Beacon policies and procedures and standards of operations.

  • Completes all required and assigned trainings.

  • Report to each scheduled shift and commence work and perform essential job function at the start of each schedule shift.

  • Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.

  • Performs special projects and other duties as assigned and required.

Position Requirements:

Education:

  • High school diploma

  • Associate’s degree or higher in a health related field preferred

Knowledge, Skills & Abilities:

  • Two or more years’ call center experience, and/or 2 plus years’ customer service experience in an office setting

  • Able to answer and resolve a high volume of member and provider calls effectively

  • Experience in managed care setting or insurance company preferred.

  • Knowledge of medical terminology preferred.

  • Ability to interact with multi-disciplinary team.

TO APPLY

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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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