Customer Care Representative I-Bilingual

Elevance Health•San Juan, PR

2d•Hybrid

About The Position

This role requires associates to be in-office 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. The Customer Care Representative I - Bilingual (US) will be responsible for successfully completing required basic training and performing basic job functions with support from co-workers, specialists, and managers on non-basic issues.

Requirements

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.
Must pass the appropriate pre-employment test battery.
Bilingual (Spanish) or multi-language skills required.
Must be able to pass a validated language test/assessment.

Nice To Haves

This position is defined as virtual, or work-from-home, however you may need to report into a local office periodically.

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 various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
Research and analyze 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.
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.
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 thinkers, 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.