Health Net, Inc. (NYSE: HNT) is among the nation’s largest publicly traded managed health care companies. Health Net’s mission is to help people be healthy, secure and comfortable. The company’s POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company’s Web site atwww.healthnet.com
The Intake Representative responds to incoming informational calls from clients and providers. Makes and verifies eligibility and benefit determinations, and explains benefit provisions to those who are eligible. This position is the entry level of the Intake Representative job family where Incumbents with knowledge of behavioral health and skills in customer service receive formal training and experience to handle most typical incoming calls. Incumbents at this level escalate unique or complicated situations to a senior level representative.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Takes appropriate steps to resolve a variety of customer service issues regarding quality assurance, provider relations, and billing.
- Explains benefit structures and authorization procedures.
- Gathers and enters demographic and preliminary clinical information.
- Applies protocol to identify cases requiring immediate clinical attention.
- Makes appropriate referrals to mental health clinicians.
- Authorizes voluntary EAP services and initial outpatient managed care treatment.
- Facilitates first phase of authorization for alternative and inpatient managed care treatment.
- Provides related clerical support. Sends out provider listings, faxes, email.
- Completes cleanup projects and other special projects.
Requires high school diploma or equivalent; college level coursework in Psychology, Social Work, Human Services or related fields is desired.
Requires minimum two years experience in a customer service setting or call center; experience in the behavioral health care field, in crisis intervention is preferred. Bilingual Spanish a plus!
Knowledge, Skills & Abilities:
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.
- Professional phone manner.
- Strong customer service experience.
- Clear and concise written communication skills for MARGIN-BOTTOM: 0px" ALIGN=center>OR
Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.
Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.
Job Field Membership & Eligibility
Organization MHN Services - 7006
Job Type Regular
Overtime Status Non-exempt