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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong communication and organizational skills while managing behavioral health inquiries and ensuring HIPAA compliance. Proficient in data entry and maintaining accurate documentation across multiple systems to support member care outcomes.
Highest-signal resume keywords
HIPAA ComplianceBehavioral Health ScreeningsClaims ProcessingCustomer ServiceData Entry
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data ProcessingClaims AssistanceEligibility VerificationAppointment SchedulingDocumentation ManagementRisk Indicator IdentificationPerformance Metrics AchievementAuthorization RequestsCrisis Situation EscalationProcess Improvement
Soft Skills
Empathetic CommunicationProblem-SolvingOrganizational SkillsTime ManagementTrust Building
Tools & Technologies
MS Office SuiteAdobe AcrobatDual-Monitor SetupHigh-Speed InternetData Entry Systems
Industry Keywords
Behavioral HealthMember CareInquiries HandlingService-Level RequirementsTeam Collaboration
About the role
Key responsibilities & impact- Serve as the primary point of contact for members and providers handling inbound behavioral health inquiries
- Verify eligibility and benefits and provide education on services
- Assist with claims and authorizations and route calls accurately
- Maintain HIPAA compliance
- Conduct behavioral health screenings
- Schedule appointments and referrals and connect members to network services
- Escalate crisis situations and clinical concerns to appropriate staff and resources
- Provide empathetic customer service and resolve routine claims inquiries
- Explain denials and submissions and escalate complex issues when appropriate
- Collaborate across teams on process improvements and operational changes
- Identify risk indicators during member interactions
- Document interactions across multiple systems and manage required paperwork
- Facilitate demographic updates and authorization requests
- Achieve performance metrics and contractual and service-level requirements
- Foster teamwork and support member care outcomes
Requirements
What you’ll need- High School Diploma
- Excellent written and verbal communication skills
- Organizational and time management skills
- Problem-solving skills
- Ability to create warmth, openness, and calmness through phone-based communication
- Ability to establish trust quickly and motivate members through an engaging motivational approach
- Flexibility in managing conversations around varied member needs and concerns
- Strong computer skills, including MS Office Suite, Adobe Acrobat, and data processing
- Proficiency with data entry across multiple systems while talking and typing simultaneously
- Ability to pass background checks upon hire and throughout employment, including criminal, employment, education, sanctions, prohibited-party, sex-offender-registry, and 10-panel drug-screen checks
- High-speed internet service with minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds
- Ability to work from a fixed, designated home workspace meeting company requirements
- Ability to use a dual-monitor desktop setup and hardwired internet connection
- Ability to adhere to a stationary workstation requirement
Benefits
Comp & perks- Quarterly performance-based, discretionary incentive
- Medical, dental, and vision coverage
- 401(k) with competitive employer match
- Company-paid life and disability insurance
- Paid parental leave and wellbeing incentives
- Generous paid time off, including volunteer time
- Flexible spending accounts for healthcare and dependent care
- Professional development opportunities and tuition reimbursement
- Remote work flexibility
- Company-provided equipment
- Opportunity for meaningful personal and professional growth
