DWIHN Call Center Representative 

Category: Non-Exempt, Professional  

Reports to:  DWIHN Call Center Director

Description: 

Reporting directly to the Call Center Manager and under the general supervision of the Call Center Director, the DWIHN Call Center Representative shall ensure that all
incoming DWIHN Call Center phone calls are answered and assessed for severity, in order to triage the call and provide the most appropriate services. 

PRIMARY DUTIES AND RESPONSIBILITIES  

• Answer all phone calls using the approved telephone answering script on one of three shifts of the DWIHN 24-hour Call Center. 
•  Assessing the call for a crisis prior to placing any call on hold. 
•  Conducting warm transfers for any caller in crisis to a crisis counselor.  
•  Identifying and transferring/referring callers to appropriate community resources  
•  Responding to request from Emergency Departments for children’s mobile crisis teams and dispatching the appropriate team. 
•  Observing and adhering to all HIPAA and Recipients Rights policies and procedures. 
•  Providing consumer–oriented , professional, and compassionate service. 
•  Documenting all incoming telephone calls.  
•  Collecting demographic information on all calls received prior to referring or transferring. 
•  Conducting warm transfers for any caller who needs a clinical assessment/screen to a Call Center Clinician.  
•  The DWIHN Call Center Representative  shall ensure all aspects of the Enrollment/Re-Enrollment process are conducted.  
•  Responding to inquiries that address enrollment and eligibility. 
•  Performing initial and enrollment changes according to The Detroit-Wayne Integrated Health Network criteria and guidelines and comply with the default CRSP assignment protocol.
•  Use the Detroit Wayne Integrated Health Network MH-WIN Database for eligibility determination, look-up, enrollment, and default CRSP assignment. 
•  Verifying consumer Wayne County residency  
•  Assigning consumers to a CRSP  via the Preference or Random request.  
•  Documenting all calls in MH_WIN. 
•  Documenting all ineligible or incomplete enrollments in the MH-WIN database.  
•  Conducting monthly TDD/TTY tests 
•  Demonstrate an understanding of the different complaint management systems of the public mental health systems and the specific benefit plans.  
•  Providing consumers with accurate information as to the grievance, appeal and local dispute resolution associated with their specific benefit plan.  
•  Gathering information in regards to the complaint/grievance and completing appropriate documentation. 
•  Ensuring all call logs and enrollment documentation are complete before the end of the work shift.  
•  The DWIHN Call Center Representative s shall ensure that all aspects of the Consumer Complaint, Grievance, and Appeals Process are forwarded to Customer Services. 
•  Documenting all compliments and complaints.  
•  Notifying supervisor immediately of consumer complaints  
•  Performing follow up calls and customer satisfaction as necessary  
•  The DWIHN Call Center Representative shall ensure that all aspects of their position
  are conducted by: 
  • Attending and /or completing monthly required trainings  
  • Attending monthly staff meetings  
  • Conducting themselves as professional members of a team and working together to assist colleagues and supervisors as needed 
  • Completing all other assigned tasks as instructed 

KNOWLEDGE, SKILLS AND ABILITIES(KSAs): 

• Advanced knowledge and expertise in system navigation and intended beneficiary orientation. 
•  Culturally proficient 
•  Interpersonal skills  
•  Advance knowledge in interviewing, investigation, and report writing skills.  
•  Excellent Telephone skills 
•  Ability to effectively communicate in writing and orally. 
•  Ability to effectively analyze, mediate and solve problems. 
•  Exceptional computer skills.  
• Openness to the emerging workforce in community mental health, i.e., people with lived experience, their family members, allies and fictive kin. 
• Healthy respect for the needs and interest of the individuals who receive services. 
•  Knowledge of, or personal experience with behavioral health issues is desired. 

REQUIRED EXPERIENCE AND TRAINING: 

Experience: 

• At least two (2) Experience working in a Call Center. 
• Experience working with complaints, grievance and appeals. 
• Experience working with Consumers, training, peer counseling and advocacy.  
• Familiarity with State mental health regulatory requirements. 

 Training: 

• Bachelor’s degree from a recognized college or university required. Bachelor’s degree in Social Work, Psychology, Counseling, etc., preferred

 WORKING CONDITIONS: 

Work is usually performed in an office setting, telecommuting optional. The DWIHN Call center is a 24/7 operation. Employees in the classification Call Center Representative may be required to work one of three shifts (Days, Afternoons, Midnights) and weekends.  

Certification/Licensure: None  

This description is not intended to be a complete statement of job content, rather to act as a summary of the essential functions to be performed. DWIHN Management
retains the discretion to add or change the position requirements at any time. 

DWIHN is an Equal Opportunity Employer