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Customer Service Representative

Customer Service Representative

Job Description

CUSTOMER SERVICE REPRESENTATIVE
Are balance and a healthy lifestyle important to you?  If you are looking for a career opportunity that supports and promotes overall well-being, look no further!  At New Directions Behavioral Health, we are dedicated to helping people find a healthy balance and improve health through positive change.  We are searching for like-minded professionals to join our team of behavior change experts in our Kansas City, Missouri office.
New Directions Behavioral Health is seeking Customer Service Representatives for our Kansas City office.  Customer service representatives are our company’s forefront. We 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 Customer Service Representative, 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 a whole, as well as strengthen our customer service department. *CB
THE CUSTOMER SERVICE REPRESENTATIVE KEY RESPONSIBILITIES INCLUDE:
  • Receive initial calls from providers, clients, and members, routing appropriate calls to their respective departments.
  • Verifying 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.
  • Triaging 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.
  • Meet internal standards set forth to comply with company contract requirements.
  • Assist coworkers in training new hires on procedural aspects of position, including documentation, orientation within the organization, and compliance rules and regulations.
  • Cross training on additional books of business as required by team.
  • Able to work simultaneously between multiple systems to provide member/provider mental health benefits.
  • Able to 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.
  • Ability to concurrently communicate telephonically and type.
  • Ability to adhere to department goals and guidelines.
  • Consistently meets individual goals for attendance, ready time, incoming calls,
documentation and quality.
  • Demonstrates use of MAGIC Customer Service concepts in all communication.
  • Willingness to work a variety of shifts if necessary.
  • Willingness to be cross trained in different lines of business.
  • Adheres to New Directions Behavioral Health Mission Statement, Core Values, Code of Business Conduct, and Compliance Program.
  • Complies with all Federal and applicable State laws and New Directions Behavioral Health Policies regarding, privacy, confidentiality, and security of health information, and other designated information.
 

Job Requirements


High School Diploma +5 years of customer service experience, or Associates degree and 3 years of customer service experience or Bachelor’s degree
Proven written and oral communication skills, organizational skills, demonstrated willingness to work within a collaborative, team-oriented environment
 
Preferred Qualifications:
5+ years customer service experience (call center preferred)
2+ 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 proficiency
 
If you’re ready to join a team of professionals that are dedicated to making a difference, we want to hear from you!
 
New Directions Behavioral Health is an Equal Opportunity Employer EOE AA M/F/Vet/Disability
We offer a very competitive compensation and benefits package.
For consideration, please apply on-line at www.ndbh.com/careers.

Job Snapshot

Employment Type Full-Time
Job Type Health Care
Education High School
Experience Not Specified
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel Not Specified
Job ID 376
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Customer Service Representative


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