Customer Care Representative

Customer Care Representative I

Location :
This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Hours :
Shift hours are 11:30 AM to 8 PM Eastern. Please adjust for your time zone. Training hours may vary.

The Customer Care Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery.

• Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
• Analyzes problems and provides information/solutions.
• Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
• Researches and analyzes data to address operational challenges and customer service issues.
• Provides external and internal customers with requested information.
• Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
• Uses computerized systems for tracking, information gathering and troubleshooting.
• Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
• Additional expectations to include but not limited to:
  Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
• Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.
• Performs other duties as assigned.

• Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.

• Call center experience strongly preferred.
• Experience working in a healthcare environment strongly preferred.
• For URAC accredited areas, the following professional competencies apply:
  Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance.

Qualified applicants with arrest…