Customer Care Representative I - Bilingual (US)

Elevance Health•San Juan, PR

2d•Hybrid

About The Position

The Customer Care Representative I - Bilingual (US) completes required basic training and performs basic job functions, with support from co-workers, specialists, and managers on non-basic issues. The role responds to customer questions by telephone and written correspondence concerning insurance benefits, provider contracts, eligibility, and claims. It analyzes problems, provides information and solutions, researches data to address operational challenges and customer service issues, and supplies requested information to internal and external customers. The representative uses a PC, image station, and computerized systems to obtain and extract information, track and troubleshoot inquiries, and document information, activities, changes, and inquiry outcomes in databases. The role develops positive customer relationships and coordinates with company functions to handle requests and questions appropriately and promptly. Under immediate supervision, it makes and receives follow-up calls and emails about routine questions. The position requires limited knowledge of company services, products, insurance benefits, provider contracts, and claims. Associates are expected to understand and respond to customer needs; multitask across calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers; and maintain focus during extended periods of sitting in a fast-paced, high-pressure environment. Strong communication, attention to detail, critical thinking, problem-solving, empathy, persistence, and comfort with digital tools are important. The role has a structured schedule, with occasional overtime or flexibility based on business needs, and may require working from an office as necessary. Other duties may be assigned. This is a hybrid role requiring associates to work in an office 1–2 days per week. Alternate locations may be considered for candidates within commuting distance of an office; candidates outside a reasonable commuting distance will not be considered unless an accommodation is granted as required by law. Elevance Health describes its workforce strategy as hybrid and may require office attendance at least once per week, with specific expectations discussed during hiring. Certain patient/member-facing roles require new candidates to be vaccinated against COVID-19 and influenza, subject to the stated exception for an acceptable explanation.

Requirements

Bilingual; the posting does not specify the languages.
Strong verbal and written communication skills for virtual and in-person interactions.
Ability to multitask across customer contacts and electronic queues while documenting information.
Ability to maintain focus during extended periods of sitting and work in a fast-paced, high-pressure environment.
Attention to detail, critical thinking, and problem-solving skills.
Empathy and persistence in resolving caller issues completely.
Comfort and proficiency with digital tools and platforms.
Ability to work a structured schedule, with occasional overtime or flexibility based on business needs, and work from the office as necessary.
Ability to work in-office 1–2 days per week and reside within reasonable commuting distance of an office, unless an accommodation is granted as required by law.
Complete required basic training.

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, image station, and computerized systems to obtain and extract information, track inquiries, gather information, and troubleshoot.
Document information, activities, database changes, and inquiry outcomes accurately for 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 follow-up telephone calls and emails to answer routine customer questions.
Handle calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers.
Perform other duties as assigned.