Customer Care Representative I

Elevance Health (Anthem); San Juan (PR); Hybrid; USD 22,000 - 32,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical

Dental

Vision

Disability benefits

401(k) + match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Job summary

Elevance Health in the United States is seeking a Customer Care Representative I (US) to handle insurance benefits, eligibility and claims inquiries under supervision. The role includes completing basic training and using digital tools to document outcomes, with a hybrid schedule requiring in-office presence 1–2 days per week.

You will respond to questions by phone and email, analyze issues, and collaborate with internal teams to resolve customer requests promptly.

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

Responsibilities

• Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
• Analyzes problems and provides information/solutions.
• Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
• Documents inquiry outcomes for accurate tracking and analysis.
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure requests are handled appropriately and timely.
• Researches and analyzes data to address operational challenges and customer service issues.
• Provides information to customers.
• Under supervision, handles routine follow-up calls and emails.
• Uses computerized systems for tracking, information gathering and troubleshooting.
• Multi-tasks across calls, texts, and queues while taking notes and talking to customers.

Skills

Oral communication

Written communication

Interpersonal skills

Problem-solving

Analytical skills

Empathy

Spanish language skills

Education

HS diploma or equivalent

Job description

Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Customer Care Representative I (US)

The Customer Care Representative I (US) will be responsible for successfully completing the required basic training and performing 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:

• Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
• Analyzes problems and provides information/solutions.
• Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
• Researches and analyzes data to address operational challenges and customer service issues.
• Provides external and internal customers with requested information.
• Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
• Uses computerized systems for tracking, information gathering and troubleshooting.
• Conducts outbound calls in the ZipDrug business area.
• Multi-tasks across calls, texts, facsimiles, and electronic queues while simultaneously taking notes and speaking to customers.
• Maintains focus during extended periods of sitting and handles multiple tasks in a fast-paced, high-pressure environment.
• Communicates effectively verbally and in writing, both virtually and in person.
• Demonstrates attention to detail, critical thinking, and problem-solving skills.
• Demonstrates empathy and persistence to resolve caller issues completely.
• Uses digital tools and platforms to enhance productivity and minimize manual efforts.
• Works a structured schedule with occasional overtime or flexibility based on business needs, including working from the office as necessary.
• Performs other duties as assigned.

Minimum Requirements:

• 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:

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

Job Level:

Non-Management Non-Exempt

Job Family:

CUS > Care Reps

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.

Benefits

• Merit increases
• paid holidays
• Paid Time Off
• 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
• financial education resources

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 agai