Behavioral Healthcare Customer Service Representative

As a Behavioral Healthcare Customer Service Representative, you will provide compassionate and professional support to members seeking behavioral and mental health services. You will assist with benefit inquiries, eligibility verification, provider information, appointment coordination, claims support, and other healthcare-related concerns while ensuring a positive member experience and maintaining compliance with healthcare regulations.

Key Responsibilities

• Respond to member inquiries regarding behavioral health benefits, eligibility, coverage, and available services.
• Assist members with finding behavioral health providers, scheduling appointments, and accessing appropriate care.
• Address inquiries related to claims, billing, authorizations, referrals, and healthcare plan benefits.
• Provide accurate information on mental health and behavioral healthcare programs, resources, and services.
• Accurately document customer interactions and maintain updated records in company systems.
• Collaborate with healthcare providers and internal departments to ensure timely resolution of member concerns.
• Ensure compliance with HIPAA, company policies, data privacy standards, and applicable healthcare regulations.
  
  

• Must be a college graduate, with or without work experience.
• Candidates who have completed at least two (2) years of college must have a minimum of six (6) months of work experience.
• Must have above-average English communication skills.
• Must be willing to work on a shifting schedule.
  
  

• 20% Night differential
• HMO coverage
• Life and Accident Insurance
• Annual increase based on performance
• 13th and 14th month pay