Customer Care Representative I-Bilingual (US)

Elevance Health•San Juan, PR

3d•Hybrid

About The Position

The Customer Care Representative I - Bilingual (US) completes required basic training and performs basic job functions with support from coworkers, specialists, and managers on non-basic issues. The role responds to customer questions by telephone and written correspondence about insurance benefits, provider contracts, eligibility, and claims; analyzes problems; and provides information and solutions. It uses computerized systems and a PC/image station to gather information, troubleshoot, track activity, and document inquiry outcomes in databases. The representative maintains positive customer relationships and coordinates with company functions to handle requests and questions appropriately and promptly. Under immediate supervision, the role handles routine follow-up calls and emails, researches data to address operational challenges and service issues, and provides information to internal and external customers. Associates are expected to multitask across calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers, and to maintain focus in a fast-paced, high-pressure environment. This role is described as virtual or work-from-home, with periodic office attendance required. The hybrid description specifies 1–2 in-office days per week and says alternate locations may be considered for candidates within commuting distance of an office. Work schedules are structured, with occasional overtime or flexibility based on business needs and the ability to work from the office as necessary.

Requirements

High school diploma or equivalent and previous experience in an automated customer service environment, or an equivalent combination of education and experience.
Bilingual Spanish or other multi-language skills are required.
Must pass a validated language test or assessment.
Must pass the appropriate pre-employment test battery.
Ability to handle multiple tasks 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 fully resolving caller issues.
Comfort and proficiency with digital tools and platforms.

Responsibilities

Respond to customer questions by telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.
Analyze customer problems and provide information and solutions.
Use a PC/image station and computerized systems to obtain and extract information, track activity, gather information, and troubleshoot.
Document information, activities, changes, and inquiry outcomes in databases for accurate tracking and analysis.
Develop and maintain positive customer relationships 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 internal and external customers.
Under immediate supervision, make and receive routine follow-up telephone calls and emails to answer customer questions.
Multitask across calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers.
Perform other duties as assigned.