Customer Care Representative II

Elevance Health is hiring a Customer Care Representative II to deliver exceptional service to health plan members, providers, and partners. In this role, you'll handle inbound inquiries, resolve benefit, claims, and eligibility questions, and provide accurate, empathetic support that improves the member experience. You'll use multiple systems to research issues, document interactions, and escalate complex cases. Working in a mission-driven, inclusive environment, you'll collaborate with cross-functional teams, receive ongoing training, and help advance whole-health solutions that positively impact communities nationwide.

Responsibilities

• Respond to inbound calls and digital inquiries from members, providers, and partners
• Research and resolve questions about benefits, eligibility, claims, and prior authorizations
• Use multiple systems and tools to verify information and document all interactions accurately
• Escalate complex or high-impact issues to appropriate teams while ensuring timely follow-up
• Educate members on plan features, digital tools, and available health resources
• Meet or exceed quality, accuracy, productivity, and customer satisfaction goals
• Collaborate with team members and other departments to improve processes and service
• Maintain confidentiality and comply with healthcare regulations and company policies

Required Skills

• Customer service
• Healthcare terminology
• Benefits and claims research
• Call center systems/telephony
• CRM software
• Data entry and documentation
• Problem solving
• De-escalation and conflict resolution
• Written and verbal communication
• Multitasking in fast-paced environment