The Advocate role is a non-clinical customer service position within an inbound call center that supports Evernorth Behavioral Health. Advocates are responsible for handling inbound calls from both members and providers or their office support staff regarding mental health or substance use disorder services. Advocates guide and assist the members and providers to help them work with Cigna/Evernorth more effectively and ensure first-call resolution.

The types of calls an Advocate service may include but are not limited to: triaging and assessing the need for clinical intervention, inquiries about provider referrals and access to care, eligibility, and benefits.

Due to the wide variety of call types, several applications are required to service these inquiries, and multiple applications are often needed within the same call. Independent problem-solving, multitasking, and technical savvy are essential in order to be able to carry out the responsibilities of this role. Calls must be serviced helpfully and professionally.

The nature of discussions within the Behavioral Advocate role often delves into personal and sensitive topics with members. It demands a nuanced understanding of mental health and substance use issues. This role differs from its medical counterpart in that mental health is a sensitive subject and staff are helping members navigate complex and emotional mental health challenges.

Responsibilities:

The primary responsibility of this role is to answer inbound calls from members and providers. The work environment is structured, and the majority of the day will be spent answering these calls from a queue. Occasional outbound calls may be necessary for issues requiring follow-up.

Within a call, an Advocate may:

Use active listening and empathy skills to triage and assess for risk of harm and substance use concerns
Coordinate with multiple matrix partners, and facilitate seamless handoffs to clinical partners for timely support
Communicate eligibility, generate a list of provider referrals, quote benefits, or advise of authorization requirements for services
Write authorizations to ensure claims are paid correctly

Provide follow-up on issues by making outbound calls when necessary
Send resources to members and providers via email
Submit a complaint on the member’s or provider’s behalf
Independently problem-solve to ensure accurate information is given, and exceptional customer service and first-call resolution is achieved

Other Posts You May Be Interested In

Other Jobs You May Be Interested In

Remote Data Entry, No Experience, $40/hr, Part-Time
Virtual Assistant, $45/hr, Remote, No Experience, Night Job
Entry-Level Remote Data Entry, $50/hr, Evening Job
Customer Support, No Degree, $40/hr, Remote, Weekend Job
Remote Phone Job, $42/hr, Part-Time, College Student Friendly
Virtual Assistant, $40/hr, Remote, No Degree, Night Job
Part-Time Data Entry, $45/hr, Remote, College Student Friendly
Remote Moderator, No Degree, $50/hr, Evening, Weekend Job
Remote Customer Support, $42/hr, Night Job, No Experience
Live Chat Support, $40/hr, Remote, Entry Level, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience
Remote Data Entry, $45/hr, No Degree, Night Shift
Part-Time Customer Support, $40/hr, Remote, College Student
Remote Live Chat, $50/hr, Part-Time, Evening/Night Job
Entry Level Phone Job, $42/hr, Remote, No Degree Required
Weekend Data Entry, $45/hr, Remote, No Experience
Remote Virtual Assistant, $40/hr, Evening, Part-Time Job
Remote Moderator, $42/hr, Part-Time, Weekend, No Degree
Data Entry, $45/hr, Remote, Night Shift, College Student Job
Phone Support, Remote, $50/hr, No Experience, Part-Time
Virtual Assistant, No Experience, $42/hr, Remote, Weekend
Remote Customer Support, $45/hr, Part-Time, College Student
Data Entry, Remote, $40/hr, Night Shift, No Degree
Evening Virtual Assistant, Remote, $45/hr, No Experience
Weekend Customer Support, $42/hr, Remote, College Student
Remote Data Entry, $50/hr, No Experience, Evening/Night Job
Remote Live Chat, $40/hr, Part-Time, No Degree Required
Virtual Assistant, $42/hr, Remote, Weekend, Entry Level
Remote Phone Support, $45/hr, Evening, No Experience Required
Data Entry, No Experience, $50/hr, Remote, College Student
Remote Moderator, $40/hr, Weekend, No Degree, Part-Time
Live Chat Support, Remote, $42/hr, Night Shift, College Student
Phone Job, $50/hr, Remote, No Degree, Part-Time, Weekend
Data Entry, $45/hr, Remote, Evening, No Experience Required
Virtual Assistant, No Experience, $42/hr, Remote, Part-Time
Remote Customer Support, $50/hr, Night Shift, No Degree
Remote Data Entry, $40/hr, College Student Friendly, Part-Time
Live Chat Support, $42/hr, Weekend, Remote, No Degree
Virtual Assistant, Remote, $45/hr, Evening, No Experience
Remote Phone Job, $50/hr, College Student, Night Shift
Remote Moderator, $42/hr, Weekend, No Experience Required
Data Entry, No Degree, $45/hr, Part-Time, Remote Job
Customer Support, $50/hr, Remote, Evening/Night Job, No Degree
Virtual Assistant, $42/hr, Remote, Weekend, No Degree
Remote Live Chat, $45/hr, College Student, No Experience
Remote Data Entry, $40/hr, Part-Time, No Degree Required
Phone Support, $50/hr, Weekend, Remote, No Experience
Virtual Assistant, $42/hr, Evening, Remote, No Degree
Remote Customer Support, $45/hr, No Experience, Part-Time
Data Entry, $50/hr, Night Job, No Degree, Remote
Remote Moderator, $40/hr, College Student Friendly, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience

Qualifications

Bachelor’s degree in the mental health field or psychology/social work-related field (family communications, health coaching, community/public health or other related major), is strongly preferred. Alternatively, a bachelor’s degree in another field or equivalent work experience, combined with 2+ years of experience in the behavioral health field will be considered

Customer Service experience
Prior experience working in a patient-focused mental health environment preferred

Ability to maintain a professional and positive image to external customers
Candidate must possess superb interpersonal communication skills
Effective listening and organizational skills, with the ability to manage multiple tasks
Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several proprietary systems
Independent problem-solving skills
Able to excel and/or have prior successful experience in a virtual team environment
Strong time management skills
Ability to type effectively and have strong PC skills

Training

Initial training for this position will be focused on member calls regarding triage, referrals, benefits, eligibility, and other support resources. Additional training on provider calls will take place once an Advocate becomes proficient in speaking to members.

vacancy remote job Behavioral Health Member Advocate (Call Center) – Bachelors Degree – Remote Job ID- 2094

Amazon
View Company Details

Tesla
View Company Details

Disney
View Company Details