About The Position

A proud member of the Elevance Health family of companies, Carelon Global Solutions, formerly Legato Health Technologies is a managed service delivery organization, providing information technology and business operations services for health plans. The Customer Care Representative 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. How you will make an impact: Responds to 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. Requires limited knowledge of company services, products, insurance benefits, provider contracts and claims. Seeks, understands and responds to the needs and expectations of internal and external customers.

Requirements

  • Requires a HS diploma or equivalent
  • Previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.
  • Bilingual (Spanish/English) or multi-language skills.
  • Must be able to pass a validated language test/assessment.

Nice To Haves

  • Full availability to work an 8-hour shift
  • Automated Customer Service experience preferred.

Responsibilities

  • Responds to 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.
  • Seeks, understands and responds to the needs and expectations of internal and external customers.

Benefits

  • We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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