Experienced Behavioral Health Customer Service Advocate – Dedicated Line – blithequark

Remote Full-time
Are you a compassionate and empathetic individual with a Master's degree, eager to make a meaningful impact in the lives of others? Do you possess exceptional communication and problem-solving skills, with a passion for delivering exceptional customer service? If so, we invite you to as a Behavioral Health Customer Service Advocate – Dedicated Line at blithequark. In this rewarding role, you will be part of a dynamic team dedicated to helping individuals access the care they need, while providing exceptional service and support to our members and providers. As a Behavioral Health Customer Service Advocate, you will be the primary point of contact for our members and providers, handling inbound calls and providing timely and accurate information to ensure seamless care coordination. About blithequark blithequark is a leading provider of pharmacy, care, and benefit solutions, committed to improving health and increasing vitality for millions of people. Our innovative approach to healthcare enables us to make a meaningful difference in the lives of our members and providers. Join us in driving growth and improving lives. Key Responsibilities: As a Behavioral Health Customer Service Advocate – Dedicated Line at blithequark, your key responsibilities will include: * Handling back-to-back phone calls from members and providers, utilizing your exceptional communication and problem-solving skills to resolve issues efficiently and effectively. * Triage and conduct intake for risk of harm and substance use concerns, ensuring timely and accurate identification of potential issues. * Communicate eligibility, assist with scheduling appointments, provide referrals, quote benefits, and advise on authorization requirements, ensuring seamless care coordination. * Utilize resources and independent judgment to deliver accurate information, exceptional service, and resolution on the first call, exceeding member and provider expectations. * Collaborate with matrix partners and coordinate seamless handoffs to clinical teams for timely support, ensuring a cohesive and effective care delivery experience. * Navigate multiple systems and applications across multiple screens while on calls, utilizing your multitasking and technical skills to ensure efficient and accurate information delivery. * Work with account-specific VIPs to ensure appropriate support for members, providing personalized and empathetic service. * Provide start-to-finish case ownership with claims, including: + Explaining how benefits were applied to claims and how claims were processed. + Supporting complex case completion and achieving resolution through necessary communication. + Working with claims examiners to determine appropriate steps in resolution. + Communicating with healthcare professionals to clarify and resolve claims issues impacting the member and provider. + Reprocessing claims as necessary. Requirements: To be successful in this role, you will need: * A Master's degree in psychology, social work, or a related field, or a Master's degree in another field plus 2+ years of behavioral health experience. * Customer service experience, with a proven track record of delivering exceptional service and support. * Strong time management and multitasking abilities, with the ability to navigate multiple systems and applications simultaneously. * Proficiency with typing and PC usage, with the ability to work efficiently in a fast-paced environment. * The ability to remain at your workstation while handling calls from a phone queue, with minimal distractions. Training Schedule and Work Schedule: * Training schedule: Monday-Friday, 8:30 AM to 5:00 PM CST. * Work schedule: Based on business need, a permanent 8-hour shift between 7:00 AM and 7:00 PM CST will be offered. Compensation and Benefits: We offer a competitive hourly rate of $24-$36 per hour, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. In addition to a comprehensive compensation package, we offer a range of benefits to support your whole health, including: * Medical, vision, dental, and well-being and behavioral health programs. * 401(k) with company match. * Company-paid life insurance. * Tuition reimbursement. * A minimum of 18 days of paid time off per year and paid holidays. About Evernorth Health Services Evernorth Health Services, a division of blithequark, creates pharmacy, care, and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention, and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Equal Employment Opportunity: Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. Reasonable Accommodation: If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response. Tobacco-Free Policy: blithequark has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. Originally posted on Himalayas
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