Behavioral Health Customer Service Rep

**Remote work but must be within 1 hour drive of Bedford, PA**
Shift - Monday-Friday 10:30am-7:00pm

JOB SUMMARY:
Provides outstanding Customer Service related to Veteran care through the Community Care Network (CCN) in a fast-paced contact center. Responds to inbound calls and chat messages regarding authorizations for medical and Behavioral Health care, provider status and availability, or claims payment and status. Accurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. May make outbound calls to schedule appointments based on Veteran or VA request. Resolves administrative eligibility discrepancies through account research and review.

EDUCATION & EXPERIENCE

Required

• High School diploma or GED
• Contact center experience to include call center chat messaging
• One year experience in a Customer Service role with performance metrics
• Experience using Microsoft Office products and the Internet

Preferred

• Healthcare industry experience to include knowledge of health services
• Military experience focusing on service delivery

KEY RESPONSIBILITIES

• Manages multiple tasks lists in accordance with directed timelines. Meets call volume, chat volume, schedule adherence, quality, Veteran appointment, and other production standards.
• Initiates and receives phone calls, chat messages and emails from VA medical center staff, and providers to answer claims, eligibility, benefit, and program questions. In select markets, facilitates appointment scheduling of Veterans through outbound solicitation to providers.
• Records veteran scheduling preferences and documents casework thoroughly in the TriWest’s Customer Relationship Management systems and Portal, as well as VA’s HSRM systems.
• Consistently displays professional and courteous service skills to internal and external customers.
• Accurately resolves VA and provider inquiries with a focus on first call resolution.
• Protects the privacy of health information of patients when using or disclosing Protected Health Information (PHI).
• Takes appropriate measures to comply with HIPAA regulations to protect privacy of customers' health information.
• Documents all communications involving Veteran and provider contacts. Uses critical thinking in problem solving and follows established processes to assure quality program compliance.
• Consistently meets department productivity and performance metrics to include regular and consistent attendance.
• Participates in cross training, employee development and flexible assignments to ensure business needs are met.

COMPETENCIES

Technical Skills

Proficient data entry skills: Ability to meet daily call and chat requirements.

Team Building / Team Player

Influence the actions and opinions of others in a positive direction and build group commitment.
Organizational Skills
Ability to organize people or tasks, adjust to priorities, learn systems within time constraints and with available resources; Detail-oriented

Information Management

Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.

High Intensity Environment

Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Empathy / Customer Service

Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position.

Coping / Flexibility

Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Computer Literacy

Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Communication / People Skills

Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.

Commitment to Task

Ability to conform to established policies and procedures; exhibit high motivation.

WORKING CONDITIONS

• Ability to cover any work shift
• Ability to work overtime, if needed
• Works within a standard office environment, with no travel
• Extensive computers work with prolonged sitting and wearing of headset

** This is a federal contract which requires a background check & drug screen to be eligible—a medical marijuana card or residency in a state where marijuana is legal does not exempt the candidate from the drug screen requirement.**

Job Type: Full-time

Pay: $17.20 per hour

Expected hours: 40 per week

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Application Question(s):

• Have you managed your own caseload in previous employment?
• Do you have experience working in a call center?
• Are you within 1 hour driving distance from Bedford, PA?

Ability to Relocate:

• Bedford, PA: Relocate before starting work (Required)

Work Location: Hybrid remote in Bedford, PA