Customer Care Representative

Position: Customer Care Representative I
Anticipated End Date:

Position Title:

Customer Care Representative I

Job Description:

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 Monday through Friday, 8:30 AM to 5:00 PM Eastern. Candidates must live within a commutable distance to one of the listed locations, and will need to report to the office for any internet outages or equipment issues.

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.

How you will make an impact:

* Answer inbound calls to the Member Services Department using the Plan's standard greeting.

* Respond to caller's inquiries and resolve member, vendor, and provider requests for information and member materials.

* Provide accurate information to callers regarding benefits, Member Handbook, and other requested information, as appropriate.

* Research, identify, and resolve caller's complaints using applicable resources and systems.

* Warm transfer calls to appropriate individuals, as required.

* Identify and escalate issues, as appropriate.

* Document all call outcomes in the electronic medical record system.

* Maintain and update member records with pertinent information, as necessary.

* Advise Members of the Plan's grievance and appeals processes, the service authorization process, and the Member's right to a fair hearing and/or external review.

* Develop and maintain effective working relationships with members, service providers, and all members of the care management team.

* Facilitate language translation and communications assistance for callers requiring special accommodations.

* Maintain knowledge of Medicaid/Medicare eligibility requirements, MLTC regulatory requirements, and internal policies and procedures.

* Provide all callers with excellent customer service and handle all calls in a respectful, culturally sensitive manner.

Minimum Qualifications:

* 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.

Preferred Skills, Capabilities and Experiences:

* Bilingual in Spanish, Cantonese, Mandarin, Bengali, or Russian strongly preferred

* Call center experience strongly preferred

* Experience in a fast-paced environment and ability to navigate multiple computer systems and learn new software strongly preferred

* Strong teamwork and collaboration skills 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.

For candidates working in person or virtually in the below locations, the salary
* range for this specific position is $16.88 to $28.94

Location(s):
New York, New Jersey

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations.

No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and…