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Be the difference that makes a difference.At New Directions, we’re in the business of changing lives. Founded in 1995, New Directions helps people live healthy, balanced lives. New Directions provides managed behavioral health services, an Employee Assistance Program, Student Assistance Program, organizational consulting and health coaching to private and public health plans, Fortune 100 companies, large and medium employers and labor groups. This strategy isn’t just applied to the 16 million individuals we serve, but to our own teams and career seekers like you. Help us change lives by starting with your own - we’re looking for bright, passionate and ambitious people to help be the difference that makes a difference.Role and Responsibilities :Benefit & Referral Specialists’ are our company’s forefront. They act as liaison to other departments within New Directions, assisting with the routing of calls, and providing the essential information to our members and their providers. As a Benefit & Referral Specialist it will be your responsibility to provide the initial connection between our callers and our company, one we feel is very important with regard to the services we provide. This will be essential to furthering our company, as well as strengthen our customer service department.
Receive initial calls from providers, clients, and members, routing appropriate calls to their respective departments.
Verify demographic information, and providing benefits, claims, and basic billing/coding information in accordance with HIPPA law. Essential that each CSR be able to handle information such as where to send claims, how to identify appropriate benefits, describe product information to providers and members, assist other departments in attempting to solve more basic issues before transferring calls.
Triage crisis callers to clinical staff for appropriate assistance. Assessing levels of risk beyond the customer service scope.
Assist with status checks of authorizations for additional services, and basic appeals inquiries.
Provide routine referrals to callers to network providers.
Provide relevant paperwork for providers to adjust demographic information in the system, and to obtain authorization for further treatment for their patients.
Cross train on additional books of business as required by team.
Able to work simultaneously between multiple systems to provider member/provider mental health benefits.
Telephonically respond to and resolve routine claims status questions and provide information related to denials or claims submission. Triage to the appropriate staff, department or third-party administrator when not routine.
Demonstrates use of MAGIC customer service concepts in all communication.
Willingness to work a variety of shifts if necessary.
Cross trained in different lines of business.
This list of duties and responsibilities is not intended to be all-inclusive and can be expanded to include other duties or responsibilities as deemed necessary.Qualified candidates will have:
High School diploma plus 5 years of customer service experience, or Associates degree and three years of experience or Bachelor’s degree.
Able to concurrently communicate telephonically and type.
Proven written and oral communication skills, organizational skills, demonstrated willingness to work within a collaborative, team-oriented environment.
PREFERRED
Five plus years customer service experience (call center preferred)
Two plus years medical billing/coding and/or claims experience (mental health preferred)
Working knowledge of health insurance as a whole
Bachelor’s degree in a social science or health related field
Spanish fluency
Why work for NDBH?Vibrant, positive cultureCaring isn’t just our job, it’s our culture. Because we believe a healthy lifestyle starts with a healthy work setting, we take great pride in fostering a friendly, caring and inspiring workplace.Community involvementNew Directions has a service program that supports a wide range of causes annually. Employees have the chance to give to those in need and volunteer through company-sponsored volunteered time off.Competitive benefitsOptimal health is our mission. That’s why we offer a robust benefit package that includes medical, dental, vision and life insurance plans. Other benefits include a 401(k) Retirement Program with company contributions, an Employee Assistance Program (EAP), Talkspace, myStrength, fitness and local discounts, and tuition and CEU/License reimbursements.Join one of the fastest-growing behavioral healthcare companies in the industry today!New Directions Behavioral Health, LLC is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identity, veteran’s status, age or disability.Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)Qualifications
Vacancy caducado!