Intake Care Senior Representative/ Healthcare Customer Service Representative

Job Title: Intake Care Senior Representative (100% REMOTE)
Actual Job Title: Case Management Lead Rep - Benefits & EAP Advocate (100% REMOTE)
Duration: 5 Months

Note:

• Training Schedule will be Monday-Friday; 8:30 AM-5:00 PM CST
• Ongoing Schedule will be Monday-Friday; 10:30 AM-7:00 PM CST OR 9:30 AM - 6:00 PM CST
• Candidates can be located in EST, but preference is CST or PST due to the schedule hours and would be later in the day for EST
• Candidates must have reliable internet connection.
• Top 3 skills needed in candidates are empathy, strong technology skills and multi-tasking.
• 1+ years of previous customer service experience/mental health or related position experience required

Duties

• The Advocate role is a non-clinical customer service position within an inbound call center that supports Client Behavioral Health. Advocates are responsible for handling inbound calls from both members and providers or their office support staff regarding mental health or substance use disorder services. Advocates guide and assist the members and providers to help them work with Client more effectively and ensure first call resolution.
• The types of calls an Advocate service may include but are not limited to: triaging and assessing the need for clinical intervention, inquiries about provider referrals and access to care, eligibility, and benefits. Due to the wide variety of call types, several applications are required to service these inquiries, and multiple applications are often needed within the same call. Independent problem solving, multitasking, and technical savvy are essential in order to be able to carry out the responsibilities of this role. Calls must be serviced in a helpful and professional manner.
• The nature of discussions within the Behavioral Advocate role often delve into personal and sensitive topics with members. It demands a nuanced understanding of mental health and substance use issues. This role differs from its medical counterpart in that mental health is a sensitive subject and staff are helping members navigate complex and emotional mental health challenges.

Responsibilities:

The primary responsibility of this role is to answer inbound calls from members and providers. The work environment is structured, and the majority of the day will be spent answering these calls from a queue. Occasional outbound calls may be necessary for issues requiring follow-up.

Within a call an Advocate may:

• Use active listening and empathy skills to triage and assess for risk of harm and substance use concerns
• Coordinate with multiple matrix partners, and facilitate seamless hand offs to clinical partners for timely support
• Communicate eligibility, generate a list of provider referrals, quote benefits, or advise of authorization requirements for services
• Write authorizations to ensure claims are paid correctly
• Provide follow-up on issues by making outbound calls when necessary
• Send resources to members and providers via email
• Submit a complaint on the members or provider’s behalf
• Independently problem-solve to ensure accurate information is given, and exceptional customer service and first call resolution is achieved

Skills:

• Customer Service experience
• Prior experience working in a patient focused mental health environment preferred
• Ability to maintain a professional and positive image to external customers
• Candidate must possess superb interpersonal communication skills
• Effective listening and organizational skills, with the ability to manage multiple tasks
• Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several proprietary systems
• Independent problem solving skills
• Able to excel and/or prior successful experience in a virtual team environment
• Strong time management skills
• Ability to type effectively and have strong PC skills

Training:

• Initial training for this position will be focused on member calls regarding triage, referrals, benefits, eligibility, and other support resources.
• Additional training on provider calls will take place once an Advocate becomes proficient in speaking to members.

Education:

• Due to the complexity of assessing members for risk of harm and substance use concerns, legal requires a bachelor’s degree in the mental health field or psychology/social work-related field (family communications, health coaching, community/public health or other related major), or a bachelor’s degree in an unrelated field and 2-3 years of experience in the behavioral health field.

About Us: Established in 2004, SPECTRA FORCE ® is one of the largest and fastest-growing diversity-owned staffing firms in the US. The growth of our company is a direct result of our global client service delivery model that is powered by our state-of-the-art A.I. proprietary talent acquisition platform, robust ISO 9001:2015/ISO 27001 certified processes, and strong and passionate client engaged teams. We have built our business by providing talent and project-based solutions, including Contingent, Permanent, and Statement of Work (SOW) services to over 140 clients in the US, Canada, Puerto Rico, Costa Rica, and India. Key industries that we service include Technology, Financial Services, Life Sciences, Healthcare, Telecom, Retail, Utilities and Transportation. SPECTRA FORCE is built on a concept of “human connection,” defined by our branding attitude of NEWJOBPHORIA®, which is the excitement of bringing joy and freedom to the work lifestyle so our people and clients can reach their highest potential. Learn more at:

Benefits: SPECTRA FORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRA FORCE provides unpaid leave as well as paid sick leave when required by law.

Equal Opportunity Employer: SPECTRA FORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at

if you require reasonable accommodation.

California Applicant Notice: SPECTRA FORCE is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting

LA County, CA Applicant Notice: If you are selected for this position with SPECTRA FORCE , your offer is contingent upon the satisfactory completion of several requirements, including but not limited to, a criminal background check. We consider qualified applicants with arrest or conviction records for employment in accordance with all local ordinances and state laws, including the Los Angeles County Fair Chance Ordinance for Employers (FCO) and the California Fair Chance Act (FCA). The background check assessment will consider whether a criminal history could reasonably have a direct, adverse impact on the job-related safety, security, trust, regulatory compliance, or suitability for this role. Such findings may result in withdrawal of a conditional job offer.

At SPECTRA FORCE , we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $19.00/hr.