Address
Form of workPlease see attached qualifying questions prior to submitting candidates to request
Please Note: this position is fully remote / work from home. At this time, candidates must be willing to complete all training and work from their home. Contractors who are local to the Bloomington, MN office location have an opportunity to flex into the office if they choose. *** / Evernorth will supply all equipment, however, high speed internet is required.
Candidates must have reliable high speed internet connection at home - this will NOT be provided
*Manager seeking candidates located anywhere in the U.S. Candiates located on the west coast are ideal to staff our late shift.
Please Note: hours during training are 8:30am-5:00pm CST. After all of the training is completed, the hours for this position will be 10:30am-7:00pm CST.
Contractors will initially be trained to take calls from behavioral healthcare professionals pertaining to member benefits and eligibility type inquiries. Additional training to handle other call types will be required (contracting and Provider Relations, claims, calls from customers with ***/Evernorth insurance, etc.). Timing for this training is yet to be determined, and will be based on business need.
Duties
The Advocate role is a non-clinical customer service position within an inbound call center that supports Evernorth Behavioral Health. Advocates are responsible for handing 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 ***/Evernorth more effectively and ensure first call resolution.
The types of calls an Advocate services may include but are not limited to: 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.
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. The position is considered entry-level within Evernorth.
Within a call an Advocate may:
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
Conduct an intake with members to assess for presenting concern of risk of harm or substance use concerns
Customer Service experience
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 eligibility and benefit inquiries from healthcare providers. This training is approximately 3-4 weeks long. Additional training will be required. However, the timing for the additional training has not yet been determined, and will be based on business need. Hours during training are 8:30am-5:00pm CST. After all of the training is completed, the hours for this position will be 10:30am-7:00pm CST. Hours may vary based on business need.
Attendance Policy
Maintaining good attendance is important for all contractors and is particularly important for those newly hired to the assignment.
The Corrective Action process for a contractor who incurs an unscheduled or unapproved absence or event in his/her first 90 days of assignment is outlined below.
1st unapproved absence or event will result in a Verbal Counseling.
2nd unapproved absence or event will result in a First Notice.
3rd unapproved absence or event will result in a Final Notice.
4th unapproved absence or event will result in termination.
Late Arrivals/Early Departures
Late arrivals and early departures without the appropriate notifications count towards an unscheduled, unapproved absence. Based on business need, a manager may allow a contractor to make-up the time during that business day. However, this does not excuse the behavior.
Recording of Late arrivals
If an Advocate is late for any reason the following will determine how their time is recorded:
7 minutes to 15 minutes will be recorded as an occurrence.
15 minutes to 30 minutes will be recorded as an occurrence and time may be made up on the same day at the manager's discretion.
30 minutes or more will be recorded as an occurrence and time will be recorded as unscheduled time off. No portion of this time can be made up.
Any exceptions will be determined by the Supervisors.
If the attendance issues become excessive and/or if a trend develops that adversely impacts the contractor's productivity, performance and/or contribution to the organization, management may accelerate the corrective action process.
