Customer Care Representative I at Elevance Health

San Juan, Puerto Rico, Puerto Rico

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Not SpecifiedCompensation

Entry Level & New GradExperience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

HS diploma or equivalent
Previous experience in an automated customer service environment (or equivalent combination of education and experience)
Must pass the appropriate pre-employment test battery
Ability to complete required basic training and perform basic job functions (with help on non-basic issues)
Must be within reasonable commuting distance from San Juan office (654 Munoz Rivera, San Juan 00901) unless accommodation granted
Availability for full-time, Monday-Friday, 8-hour shift between 7 am - 7 pm AST, with hybrid schedule (2 days in office: Monday and Wednesday)
Limited knowledge of company services, products, insurance benefits, provider contracts, and claims
Proficiency in maintaining focus during extended sitting, handling multiple tasks in fast-paced environment
Strong verbal and written communication skills for virtual and in-person interactions
Attentive to details, critical thinker, problem-solver
Demonstrates empathy and persistence to resolve issues
Comfort and proficiency with digital tools, platforms, PCs, image stations, computerized systems (including typing, learning new systems, Microsoft products)
Ability to multitask (e.g., handling calls, texts, facsimiles, electronic queues while taking notes and speaking to customers)

Responsibilities

Successfully complete required basic training
Respond to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims
Analyze problems and provide information/solutions
Operate PC/image station to obtain/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
Coordinate with various company functions to ensure customer requests/questions are handled appropriately and timely
Research and analyze data to address operational challenges and customer service issues
Provide external and internal customers with requested information
Under immediate supervision, receive and place follow-up telephone calls/e-mails to answer routine customer questions
Use computerized systems for tracking, information gathering, and troubleshooting
Seek, understand, and respond to needs/expectations of internal/external customers
Perform other duties as assigned

Skills

Customer Service

Telephone Support

Written Correspondence

Insurance Benefits

Claims Processing

Eligibility Verification

PC Operation

Database Documentation

Problem Analysis

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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