Customer Care Representative I

Elevance Health • San Juan, PR

1d • Hybrid

About The Position

The Customer Care Representative I (US) completes required basic training and performs basic job functions, receiving support from co-workers, specialists, and managers on non-basic issues. The role responds to internal and external customer questions about insurance benefits, provider contracts, eligibility, and claims, and provides information or solutions by researching and analyzing problems and data. The representative uses computerized systems and digital tools to gather information, troubleshoot, document activity, and track inquiries and outcomes. The position works under immediate supervision, handling routine follow-up calls and emails and conducting outbound calls in the ZipDrug business area. It requires multitasking across calls, texts, facsimiles, and electronic queues while taking notes and communicating with customers. The role is hybrid, requiring office attendance 1–2 days per week, and may require occasional overtime or schedule flexibility based on business needs. The representative must pass the appropriate pre-employment test battery.

Requirements

• High school diploma or equivalent, and previous experience in an automated customer service environment; or an equivalent combination of education and experience.
• Must pass the appropriate pre-employment test battery.
• Ability to maintain focus during extended periods of sitting and handle multiple tasks in a fast-paced, high-pressure environment.
• Attention to detail, critical thinking, and problem-solving skills.
• Empathy and persistence in resolving caller issues completely.

Nice To Haves

• Strong oral, written, and interpersonal communication skills.
• Problem-solving skills.
• Facilitation skills.
• Analytical skills.
• Spanish language skills.

Responsibilities

• Respond to internal and external customer questions by telephone and written correspondence about insurance benefits, provider contracts, eligibility, and claims.
• Analyze problems and provide information and solutions.
• Operate a PC/image station to obtain and extract information; 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 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, make and receive follow-up telephone 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.
• Multitask across calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers.
• Communicate effectively verbally and in writing, virtually and in person.
• Use digital tools and platforms to enhance productivity and minimize manual efforts.
• 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.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical benefits
• Dental benefits
• Vision benefits
• Short- and long-term disability benefits
• 401(k) with company match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED