Senior Behavioral Health Representative

Join Our Team: Do Meaningful Work and Improve People’s Lives

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership.

Forbes ranked Premera among America’s 2023 Best Midsize Employers because we are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!

As a Senior Behavioral Health Representative, you will provide inbound and/or outbound customer service support, ensuring delivery of accurate, complete, and timely information pertaining to member policies and coverage and thoroughly documenting all calls. You will conduct research to provide claims status, as well as investigate routine requests and escalate all call issues as required. You will provide high level service to both members and providers or other BlueCard plans and perform complex project work in multiple geographic locations, covering individual and group plans for all types of insurance coverage.

This is a virtual/telecommuter position, working from home.

What you’ll do:

• Route inquiries needing further investigation to the appropriate department or vendor.
• Accountable for inbound and/or outbound phone-based customer service for customers/members and providers, providing first call and/or email resolution to complex call types and/or multiple lines of business. Provide caller education through clear and accurate exchange of information.
• Resolve all issues for members which may include conducting research and escalating issues as needed.
• Provide support to other Customer Service Representatives (CSRs) as required including Assist Queue or floor support.
• Interact with all members via phone, email, or other electronic methods, and in person to meet their needs. May call external agencies or vendors on behalf of the member to resolve inquiries.
• Respond to member calls regarding benefits, billing, eligibility, enrollment, appeals, prior authorization, and prescription questions.
• Follow-up, resolve, and document issues of each call.
• Address complex problems and issues for multiple lines of business and/or call types. Conduct complex research to resolve problems and issues.
• Follow up on pended items and route incoming paperwork in a timely manner to correct departments for completion.
• Work with highly sensitive information while maintaining Personal Protected Information (PPI) requirements.

What you’ll bring:

• (18) months of previous customer service experience. (Required)
• Phone related customer service experience.
• Completion of formal Premera customer service training program.(2) years of college level courses or equivalent experience preferred.
• Ability to understand and translate medical terms into plain language for our members.
• Knowledge of medical, pharmacy, and Blue Cross Blue Shield Association guidelines and policies.
• Healthcare, benefits, call center, claims processing or Facets experience.
• Bilingual proficiency in a particular language (English/Spanish) with the ability to articulate messages and information clearly and accurately preferred.

What We Offer

• Generous Paid Time Off to reenergize
• Retirement programs (401K employer match and pension plan)
• Tuition assistance for undergraduate and graduate degrees
• Medical, vision and dental coverage
• Life and disability insurance
• Wellness incentives, onsite services, a discount program and more
• Free parking

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at [email protected] or via phone at 425-918-4785.

Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.

National Salary Range:

$41,600.00 - $62,400.00

National Plus Salary Range:

$47,000.00 - $70,500.00

• National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.