Behavioral Health Customer Care Representative I

Elevance Health•Seven Fields, PA

6d•Remote

About The Position

The Behavioral Health Customer Care Representative I completes required basic training and performs routine customer care functions with immediate supervision. The role responds to internal and external customer inquiries about insurance benefits, provider contracts, eligibility, and claims, and researches issues to provide information or solutions. Associates use computerized systems and a PC/image station to gather information, troubleshoot, track activity, and document inquiry outcomes in databases. This role is virtually full-time, with required in-person training and the ability to work from the office when necessary. Candidates must live within a commutable distance of Seven Fields, Pennsylvania. The structured schedule is Monday through Friday, either 8:00 a.m.–4:30 p.m. Eastern or 8:30 a.m.–5:00 p.m. Eastern on a rotating schedule. Occasional overtime or schedule flexibility may be needed based on business requirements. The position requires handling multiple communication channels and tasks at once in a fast-paced, high-pressure environment. It calls for sustained focus while sitting, strong communication, attention to detail, critical thinking, problem-solving, empathy, persistence, and comfort using digital tools. Other duties may be assigned.

Requirements

High school diploma or equivalent and previous experience in an automated customer service environment, or an equivalent combination of education and experience.
Pass the appropriate pre-employment test battery.
Ability to complete required basic training and perform basic job functions, seeking help from co-workers, specialists, and managers for non-basic issues.
Ability to multitask and maintain focus during extended periods of sitting in a fast-paced, high-pressure environment.
Strong verbal and written communication skills for virtual and in-person interactions.
Attention to detail, critical thinking, and problem-solving skills.
Empathy and persistence in resolving caller issues completely.
Comfort and proficiency with digital tools and platforms.
Ability to work the stated Monday-through-Friday rotating schedule and occasional overtime or schedule flexibility based on business needs.

Nice To Haves

For URAC-accredited areas, strong oral, written, and interpersonal communication, problem-solving, facilitation, and analytical skills.

Responsibilities

Respond to internal and external customer inquiries by telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.
Analyze customer problems and provide information or solutions.
Use a PC/image station and computerized systems to obtain information, track requests, troubleshoot, and document information, activities, and changes in databases.
Thoroughly document inquiry outcomes for accurate tracking and analysis.
Develop and maintain positive customer relations and coordinate with company functions to handle requests and questions appropriately and promptly.
Research and analyze data to address operational challenges and customer service issues.
Provide requested information to external and internal customers.
Under immediate supervision, make and receive follow-up calls and emails to answer routine customer questions.
Handle calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers.
Complete other duties as assigned.