Customer Care Representative I - Bilingual (US)

Elevance Health•Mayagüez, PR

4d•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 about insurance benefits, provider contracts, eligibility, and claims through telephone and written correspondence; researches and analyzes information; and documents inquiry outcomes and activity in company systems. The representative works under immediate supervision and handles routine follow-up calls and emails, while coordinating with internal functions to resolve customer requests in a timely manner. The position requires Spanish or other multilingual capability and passing a validated language assessment. The role is hybrid, with associates expected to work in-office 1–2 days per week and to be within reasonable commuting distance of the posting location unless an accommodation is granted. The work schedule is structured, with occasional overtime or flexibility based on business needs.

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.
Bilingual Spanish or other multi-language skills required.
Pass a validated language test or assessment.
Ability to multitask in a fast-paced, high-pressure environment and maintain focus during extended periods of sitting.
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 using digital tools and platforms.
Ability to work a structured schedule, with occasional overtime or flexibility based on business needs, and to work from an office as necessary.

Responsibilities

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