Join Evernorth Health Services as a Provider Relations & Claims Advocate supporting our Behavioral Health services. In this remote, phone-based role, you'll be responsible for servicing a high volume of inbound calls from members and providers to resolve claims and provider relations inquiries.
What You'll Do
- Answer inbound calls regarding claims, contracting, and provider relations from members and providers.
- Work in a structured call queue environment, handling back-to-back calls throughout the day.
- Make outbound calls as needed for issue resolution or follow-up.
- Use multiple applications simultaneously to research and resolve inquiries.
- Handle topics like claim status, reprocessing requests, provider contract questions, authorization corrections, duplicate EOB requests, and complaint submissions.
- Escalate issues via Advocate Handoff/Help Request (AHHR).
- Email resources and documentation to callers.
What We're Looking For
- A Bachelor’s degree is required.
- Proven customer service experience.
- Ability to thrive in a virtual team environment.
- Strong interpersonal and communication skills.
- Effective listening and organizational abilities.
- Technical aptitude with multiple systems and applications.
- Independent problem-solving and time management skills.
- Proficient typing and PC skills.
Nice to Have
- Prior experience in an Evernorth Behavioral Care Specialist or Advocacy role.
- Experience handling behavioral health claims and provider relations calls.
Benefits & Compensation
- Hourly compensation of $24 - $36.
- Medical, vision, dental, and well-being and behavioral health programs.
- 401(k) plan.
- Company paid life insurance.
- Tuition reimbursement.
- Minimum of 18 days of paid time off per year.
- Paid holidays.
- Annual bonus plan eligibility.
Work Mode
This is a fully remote position.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
