Care Navigator

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the main point of contact for members and providers by addressing behavioral health inquiries, confirming eligibility and benefits, providing service education, assisting with claims and authorizations, and ensuring proper call routing while adhering to HIPAA regulations.

• Perform behavioral health screenings, arrange appointments and referrals, connect members to network services, and escalate crisis situations to clinical staff as needed.

• Deliver compassionate customer service, resolve standard claims inquiries, clarify denials and submissions, and escalate more complex issues when necessary.

• Collaborate with various teams on process enhancements, stay updated on operational changes, identify risk indicators, and escalate clinical issues as appropriate.

• Record all interactions across multiple systems, manage necessary paperwork, and facilitate demographic updates and authorization requests.

• Meet performance metrics, collaborate with teams, promote teamwork, and strive to meet or exceed contractual and service-level expectations.

⛳️ Requirements

• High School Diploma

• Exceptional written and verbal communication abilities

• Strong organizational and time management skills

• Effective problem-solving capabilities

• Capacity to foster warmth, openness, and calmness during phone communications

• Ability to quickly build trust and motivate members

• Flexibility in managing discussions around diverse member needs and concerns

• Proficient computer skills, including MS Office Suite, Adobe Acrobat, and data processing

• Skilled in data entry across multiple systems while engaging in conversation and typing simultaneously

• Commitment to enhancing access to quality behavioral healthcare

• Must pass background checks upon hire and periodically during employment, including criminal, identity, education, employment, sanctions, prohibited parties, sex offender registry, and 10-panel drug screening

• Strong interpersonal and communication skills with diverse populations

• Effective critical thinking and problem-solving abilities

• Capacity to navigate and multitask across several computer applications while conversing

• Quiet home workspace with minimal background noise

• High-speed internet installed prior to starting: minimum 20 Mbps download, 5 Mbps upload, and maximum 100 ms latency

• Ability to work from a designated home workspace that meets connectivity, noise reduction, control, and ergonomic standards

• Capacity to remain seated and engaged in call queues for extended periods

• Ability to utilize a dual-monitor desktop setup, hardwired internet connection, and company-provided equipment

• Compliance with a stationary workstation requirement

🏝️ Benefits

• Hourly compensation ranging from $18.40 to $22

• Quarterly performance-based discretionary incentives

• Coverage for medical, dental, and vision

• 401(k) plan with competitive employer matching

• Company-sponsored life and disability insurance

• Paid parental leave and wellness incentives

• Generous paid time off, including time for volunteering

• Flexible spending accounts for healthcare and dependent care

• Opportunities for professional development and tuition reimbursement

• Flexibility to work remotely

• Opportunity for significant personal and professional growth

• Equipment provided by the company