Behavioral Health Customer Care Representative I

Job Description

Behavioral Health Customer Care Representative I

Location : Virtual, (in California or Nevada) this role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid / virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hours : Monday - Friday, 8 : 30 am - 5 pm PST .

The Behavioral Health Customer Care Representative I is responsible for successfully completing the required training in order to perform basic job functions. The main function will be answering incoming Behavioral Health and / or Employee Assistance Program calls, as well as making outbound calls to members or providers.

How will you make an impact :

Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.

Completing intake procedure and determine whether member needs to be screened for safety.

Provide information regarding member’s Behavioral Health, Employee Assistance Program, and Worklife referrals available to member and dependents.

Operates a PC and laptop with dual monitors to obtain and extract information; documents information, activities and changes in the database.

Analyze problems provide with information and solutions.

Documents each call / inquiry received either from members, providers, employers and / or others calling in for tracking and analysis.

Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

Researches and analyzes data to address operational challenges and customer service issues.

Process external and internal information member or providers provide in order to process payment for services.

Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.

Uses computerized systems for tracking, information gathering and troubleshooting.

Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.

Additional expectations to include but not limited to : Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.

Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.

Performs other duties as assigned.

Requires knowledge of company, department, services and products in order to service members and process requests to assure services are rendered and appropriately handles.

Follows company and department policies and procedures in order to complete and pass monthly audit / call reviews.

Complete weekly or monthly assignments and trainings as part of the monthly and yearly review.

Minimum Requirements :

Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Qualifications :

• For URAC accredited areas, the following professional competencies apply : Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
• Due to the nature of the Behavioral Health Resource Center and Employee Assistance Program, candidates must display the ability to show empathy to callers and be able to focus on listening to callers’ needs.
• Previous experience with use of computers as it pertains to typing, learning new systems and ability to use some Microsoft products.
• Candidate must be able to follow all procedures as outlined in job aids and other forms of communication.
• Ability to work independently and are able to de-escalate callers as needed.
• Work using PC and entering data using different programs from EAP HIP, BH HIP, Genesys Cloud, WGS, Member 360 to Microsoft Word, Outlook, Excel and other systems needed to complete requests.

For candidates working in person or virtually in the below location(s), the salary

Locations : California and Nevada

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Job Level :

Non-Management Non-Exempt

Workshift :

1st Shift (United States of America)

Job Family : CUS >

Care Reps

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact