Contact Center Assistant Senior - Quest Behavioral Health - Day

Contact Center Assistant Senior - Quest Behavioral Health - Day

Location: York Hospital, York, PA

Schedule: Full Time

Hours

Full-Time: 80 Hours/Biweekly

8:30am - 5:00pm

General Summary

Explains benefit coverage, answers members' questions and inquiries, and documents appropriately. Uses exceptional customer service practices. Represents Quest in a professional and positive manner. Requires an intermediate degree of technical and communications/interpersonal skills, knowledge, and ability. May participate in programs, projects, and/or processes as assigned. Works collaboratively with care management, claims and provider relations staff for the good of Quest members and providers.

Duties and Responsibilities

Essential Functions

• Answers and manages a high volume of fast paced incoming telephone calls. Places outbound calls as needed. Provides exceptional customer service at all times by identifying and addressing member needs in a professional, positive, and caring manner.

• Enters and maintains detailed information in confidential member records.

• Manages work queues within the electronic health record (Epic).

• Manages and completes registrations for MyQuestBH and addresses inbox messages received.

• Understands and demonstrates knowledge of insurance and enters information appropriately into the electronic health record.

• Explains benefit coverage and/or claim status to members and/or providers through verbal or written communications.

• Interacts with appropriate sources to answer members' questions/inquiries and resolves member concerns and problems appropriately through verbal or written communications.

• Collaborates with care management staff based on individual situations to address member needs. Works closely with claims and provider relations teams to address member and/or provider inquiries and concerns.

• Opens and routes incoming mail; distributes correspondence and other material to staff. Prepares outgoing mail, appropriately following policies and procedures.

• Contacts provider offices or other departments when necessary to obtain additional information on behalf of the member.

• Assists members by offering in-network provider information and/or securing appointments as appropriate.

• In close collaboration with care management, participates in a variety of departmental teams focused on supervisory referrals and autism services.

• Supports providers in utilizing Tapestry Link for claim submission.

• Assists members with navigation and questions related to the Quest website.

• Uses appropriate resources available to provide general information to members.

• Serves as a resource to their team and answers any questions, as well as uses critical thinking to resolve issues and concerns real-time.

• Under direction of the Supervisor, assists in training new staff when assigned and provides ongoing support and instruction when they become independent. Communicates new hire's progress and performance with Supervisor.

• Works various reports as assigned and makes proactive recommendations in updating department resources and reference materials. May assist in process improvement initiatives as identified.

• Assists leadership as requested and handles sensitive/difficult situations appropriately.

• Consistently displays good judgement, decision-making and independence, and can effectively function with limited guidance and supervision.

• Participates in answering questions from staff using internal messaging and follows up when necessary.

• Promotes active engagement of all employees and supports recognition of staff accomplishments.

Common Expectations

• Adheres to established policies and procedures, objectives, quality assessment, and safety standards.

• Maintains professional growth and development.

• Maintains appropriate records, reports, and files as required for the department.

• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

• Participates in educational programs and staff meetings required for the department.

• Greets and directs visitors when needed.

Qualifications

Minimum Education

• High School Diploma or GED Required

• Associates Degree Preferred or

• Bachelors Degree Preferred

Work Experience

• 2 years Relevant experience. Required

• Customer service experience. Preferred

Courses and Training

• Complete Medical Terminology course. within 1 year Required

Knowledge, Skills, and Abilities:

• Excellent communication and interpersonal skills.

• Basic computer skills with knowledge of Microsoft Office suite.

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