Customer Care Representative I

Elevance Health•Denver, CO

1d•Remote

About The Position

The Customer Care Representative I completes required basic training and performs basic customer-care functions, with assistance from co-workers, specialists, and managers for non-basic issues. The role responds to internal and external customer questions about insurance benefits, provider contracts, eligibility, and claims; analyzes issues and provides information or solutions; and documents inquiries and outcomes in company systems. The representative uses computerized tools to research information, track activity, troubleshoot, and address operational and customer-service challenges. Under immediate supervision, the representative handles routine follow-up calls and emails and conducts outbound calls in the ZipDrug business area. The role requires managing multiple communication channels and queues while documenting interactions, maintaining focus in a fast-paced environment, and communicating with customers virtually and in person. The position is virtual full-time except for required in-person training sessions; candidates must reside within a reasonable commuting distance of a posting location unless an accommodation is granted. Work hours are Monday through Friday, 8:00 AM to 4:30 PM MST, with occasional overtime or schedule flexibility based on business needs and office work as necessary. The appropriate pre-employment test battery must be passed.

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.

Nice To Haves

2–3 years of healthcare experience.
2–3 years of call-center experience.
Bilingual ability.
Strong oral, written, and interpersonal communication skills.
Problem-solving skills.
Facilitation skills.
Analytical skills.

Responsibilities

Respond to internal and external customer questions by telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.
Analyze problems and provide information or solutions.
Use a PC and image station to obtain and extract information, and document information, activities, and changes in the database.
Thoroughly document inquiry outcomes for accurate tracking and analysis.
Develop and maintain positive customer relations and coordinate with company functions to handle customer requests and questions appropriately and promptly.
Research and analyze data to address operational challenges and customer-service issues.
Provide internal and external customers with requested information.
Under immediate supervision, receive and place follow-up calls and emails to answer routine customer questions.
Use computerized systems for tracking, information gathering, and troubleshooting.
Conduct outbound calls in the ZipDrug business area.
Manage calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers.
Communicate effectively, verbally and in writing, both virtually and in person.
Demonstrate attention to detail, critical thinking, and problem-solving skills.
Show empathy and persistence to resolve caller issues completely.
Use digital tools and platforms to improve productivity and minimize manual work.
Work a structured schedule, with occasional overtime or flexibility based on business needs, including working from the office as necessary.
Perform other duties as assigned.