Customer Service Representative - Behavioral Health
Core
Advocate care for members by guiding them through benefit plans, resolving claims, and connecting them with behavioral health resources.
Role type
Customer Service Representative (Behavioral Health)
Builds
Member support and claims resolution for Aetna behavioral health plans
Domain
Healthcare / Behavioral Health Insurance
Deliverable
client delivery
Required skills
Active listening, claims tracking, benefit plan explanation, regulatory guideline knowledge, de-escalation, email communication, database management
Preferred skills
Mental health background, bilingual/multilingual skills, remote work experience
Responsibilities
Answer inbound member calls, review claim history for benefit maximums, explain member rights and responsibilities, connect members with external resources, handle complaints and inquiries, send outbound emails, escalate complex queries
Seniority
Entry to Mid-level, hands-on IC
