Customer Care Representative I

Anticipated End Date:

Position Title:

Job Description:

Customer Care Representative I

Location: This role enables associates to work virtually full-time except for required in-person training sessions providing maximum flexibility and autonomy. This approach promotes productivity supports work-life integration and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless accommodation is granted as required by law.

Hours: Shift hours are Monday through Friday 8:30 AM to 5:00 PM Eastern. Candidates must live within a commutable distance to one of the listed locations and will need to report to the office for any internet outages or equipment issues.

The Customer Care Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery.

How you will make an impact:

• Answer inbound calls to the Member Services Department using the Plans standard greeting.

• Respond to callers inquiries and resolve member vendor and provider requests for information and member materials.

• Provide accurate information to callers regarding benefits Member Handbook and other requested information as appropriate.

• Research identify and resolve callers complaints using applicable resources and systems.

• Warm transfer calls to appropriate individuals as required.

• Identify and escalate issues as appropriate.

• Document all call outcomes in the electronic medical record system.

• Maintain and update member records with pertinent information as necessary.

• Advise Members of the Plans grievance and appeals processes the service authorization process and the Members right to a fair hearing and/or external review.

• Develop and maintain effective working relationships with members service providers and all members of the care management team.

• Facilitate language translation and communications assistance for callers requiring special accommodations.

• Maintain knowledge of Medicaid/Medicare eligibility requirements MLTC regulatory requirements and internal policies and procedures.

• Provide all callers with excellent customer service and handle all calls in a respectful culturally sensitive manner.

Minimum Qualifications:

• Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills Capabilities and Experiences:

• Bilingual in Spanish Cantonese Mandarin Bengali or Russian strongly preferred

• Call center experience strongly preferred

• Experience in a fast-paced environment and ability to navigate multiple computer systems and learn new software strongly preferred

• Strong teamwork and collaboration skills strongly preferred

• For URAC accredited areas the following professional competencies apply: Associates in this role are expected to have strong oral written and interpersonal communication skills problem-solving skills facilitation skills and analytical skills.

For candidates working in person or virtually in the below locations the salary* range for this specific position is $16.88 to $28.94

Location(s): New York New Jersey

In addition to your salary Elevance Health offers benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender race or any other category protected by federal state and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location work experience education and/or skill level. Even within the range the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned vested and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus commission benefits or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Companys sole discretion consistent with the law.

Job Level:

Workshift:

Job Family:

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success - for our consumers our associates our communities and our business.

We offer a range of market-competitive total rewards that include merit increases paid holidays Paid Time Off and incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) match stock purchase plan life insurance wellness programs and financial education resources to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 Florida Agency for Health Care Administration.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13 the posting will automatically come down on 3/12 at 11:59:59 other words the job is posted until 3/13 not through 3/13.