PartnersACCESS Call Center Representative (Remote-NC)
Partners Health Management, Elkin, NC, United States
Overview
Competitive Compensation & Benefits Package available. The primary purpose of this position is to provide nonclinical administrative support to the PartnersACCESS call center. The Call Center Representative answers inbound calls, assists callers by connecting them to the appropriate party, shares information, provides technical assistance, answers questions, and handles or resolves complaints. The role requires a high level of professionalism, patience and empathy when working with callers who may be frustrated and may have complex medical, behavioral health, intellectual and other developmental conditions, with a focus on first-call resolution and customer satisfaction. Must live in North Carolina and preferably in Partners counties.
Primary Purpose of Position This position provides nonclinical administrative support to the PartnersACCESS call center. The Call Center Representative primarily answers inbound calls, assists callers by connecting them to the appropriate party, shares information, provides technical assistance, answers questions, and handles and/or resolves complaints. The role requires maintaining a high level of professionalism, patience and empathy when working with callers who may be frustrated and may have complex medical, behavioral health, intellectual and other developmental conditions, while maintaining the highest level of customer satisfaction by seeking first-call resolution.
Benefits and Location
Annual incentive bonus plan
Medical, dental, and vision insurance with low deductible/low-cost health plan
Generous vacation and sick time accrual
12 paid holidays
State Retirement (pension plan)
401(k) Plan with employer match
Company paid life and disability insurance
Wellness Programs
Public Service Loan Forgiveness Qualifying Employer
Office Location:
Remote option; Available for any of Partners' NC locations
Closing Date:
Open Until Filled
Role and Responsibilities
Ability to learn complex information about two Medicaid health plans and their benefits.
Work in a call center environment and interact with callers who are generally members and providers, to deliver information, answer frequently asked questions, and address complaints.
Route calls to the appropriate resource, including identifying and elevating more complex or crisis calls.
Understand Health/Mental Health (MH)/Substance Use (SU)/Traumatic Brain Injury (TBI)/Intellectual/Developmental Disability (I/DD) treatment needs, benefit information and referral of members calling to determine if they may potentially qualify for services.
Review call notes, enrollments, registrations, or other identified documents for completeness and/or accuracy.
Collect and enter demographic data into the electronic record, complete appropriate forms, explain services, benefits and resources, verify Medicaid and dispatch.
Provide follow-up calls.
Maintain a high level of accuracy and confidentiality in line with NC standards, state and federal laws and LME/MCO and NCQA standards, procedures, policies and protocol.
Trained on the requirements, policies and procedures of the BH I/DD Tailored Plan operating in North Carolina and able to respond to all areas within the Member Handbook and Provider Manual, including resolving claims payment inquiries in one touch.
Automation
Screenings are completed using standard and specialized computer programs.
Inputs accurate information into the system and unlocks electronic service records with appropriate consents; enters all necessary data elements into data systems.
Cooperative Efforts
Must be a team player and have a positive attitude.
Establish and maintain effective working relationships within the unit, agency, and service system.
Demonstrate professionalism, tact and diplomacy when handling volatile callers and/or working with contract providers and other external parties.
Participate in Unit Staff meetings, Agency Staff meetings, All Staff meetings, and assigned committees.
Interact by phone with providers to provide information in response to inquiries, concerns, and questions.
Interact with providers to provide information about services and other resources.
BH I/DD Tailored Plan eligibility and services.
Knowledge, Skills and Abilities
Knowledge of health, mental health, substance use, traumatic brain injury and intellectual/developmental disability service delivery and NC Medicaid Managed Care system, plus community resources.
Call center functions, member population, potential for crisis issues, confidentiality laws and program protocols/policies.
High level computer skills.
Ability to communicate effectively orally and in writing, good keyboarding skills and the ability to multi-task.
Ability to provide technical assistance to both members and providers.
Ability to maintain confidentiality when screening and referring calls.
Education/Experience Requirements Required: High School diploma and at least one (1) year of healthcare and/or MH/SU/IDD/TBI experience.
Preferred: Associate degree or higher and one (1) year of healthcare or MH/SU/IDD/TBI experience, or Associate Degree in Nursing (ADN) and at least one (1) year of healthcare and/or MH/SU/IDD/TBI experience. Bilingual preferred (for one of the positions).
Licensure/Certification N/A
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Primary Purpose of Position This position provides nonclinical administrative support to the PartnersACCESS call center. The Call Center Representative primarily answers inbound calls, assists callers by connecting them to the appropriate party, shares information, provides technical assistance, answers questions, and handles and/or resolves complaints. The role requires maintaining a high level of professionalism, patience and empathy when working with callers who may be frustrated and may have complex medical, behavioral health, intellectual and other developmental conditions, while maintaining the highest level of customer satisfaction by seeking first-call resolution.
Benefits and Location
Annual incentive bonus plan
Medical, dental, and vision insurance with low deductible/low-cost health plan
Generous vacation and sick time accrual
12 paid holidays
State Retirement (pension plan)
401(k) Plan with employer match
Company paid life and disability insurance
Wellness Programs
Public Service Loan Forgiveness Qualifying Employer
Office Location:
Remote option; Available for any of Partners' NC locations
Closing Date:
Open Until Filled
Role and Responsibilities
Ability to learn complex information about two Medicaid health plans and their benefits.
Work in a call center environment and interact with callers who are generally members and providers, to deliver information, answer frequently asked questions, and address complaints.
Route calls to the appropriate resource, including identifying and elevating more complex or crisis calls.
Understand Health/Mental Health (MH)/Substance Use (SU)/Traumatic Brain Injury (TBI)/Intellectual/Developmental Disability (I/DD) treatment needs, benefit information and referral of members calling to determine if they may potentially qualify for services.
Review call notes, enrollments, registrations, or other identified documents for completeness and/or accuracy.
Collect and enter demographic data into the electronic record, complete appropriate forms, explain services, benefits and resources, verify Medicaid and dispatch.
Provide follow-up calls.
Maintain a high level of accuracy and confidentiality in line with NC standards, state and federal laws and LME/MCO and NCQA standards, procedures, policies and protocol.
Trained on the requirements, policies and procedures of the BH I/DD Tailored Plan operating in North Carolina and able to respond to all areas within the Member Handbook and Provider Manual, including resolving claims payment inquiries in one touch.
Automation
Screenings are completed using standard and specialized computer programs.
Inputs accurate information into the system and unlocks electronic service records with appropriate consents; enters all necessary data elements into data systems.
Cooperative Efforts
Must be a team player and have a positive attitude.
Establish and maintain effective working relationships within the unit, agency, and service system.
Demonstrate professionalism, tact and diplomacy when handling volatile callers and/or working with contract providers and other external parties.
Participate in Unit Staff meetings, Agency Staff meetings, All Staff meetings, and assigned committees.
Interact by phone with providers to provide information in response to inquiries, concerns, and questions.
Interact with providers to provide information about services and other resources.
BH I/DD Tailored Plan eligibility and services.
Knowledge, Skills and Abilities
Knowledge of health, mental health, substance use, traumatic brain injury and intellectual/developmental disability service delivery and NC Medicaid Managed Care system, plus community resources.
Call center functions, member population, potential for crisis issues, confidentiality laws and program protocols/policies.
High level computer skills.
Ability to communicate effectively orally and in writing, good keyboarding skills and the ability to multi-task.
Ability to provide technical assistance to both members and providers.
Ability to maintain confidentiality when screening and referring calls.
Education/Experience Requirements Required: High School diploma and at least one (1) year of healthcare and/or MH/SU/IDD/TBI experience.
Preferred: Associate degree or higher and one (1) year of healthcare or MH/SU/IDD/TBI experience, or Associate Degree in Nursing (ADN) and at least one (1) year of healthcare and/or MH/SU/IDD/TBI experience. Bilingual preferred (for one of the positions).
Licensure/Certification N/A
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