Customer Care Representative I

The Elevance Health Companies of Puerto Rico, LLC; San Juan (PR); Hybrid; USD 32,000 - 42,000; Full time

Benefits offered by this job

Hybrid work arrangement

Health benefits

Job summary

The Elevance Health Companies of Puerto Rico, LLC is seeking a Customer Care Representative I to handle basic customer inquiries related to insurance benefits, eligibility, and claims. The role includes training, data entry, and collaboration with coworkers and managers to resolve routine issues.

Hybrid 1: in-office 1-2 days per week with flexibility based on business needs. Must pass pre-employment testing and meet vaccination policy requirements.

Qualifications

• HS diploma or equivalent; experience in automated customer service preferred.
• Spanish language skills preferred.
• Strong communication and interpersonal abilities required.

Responsibilities

• Responds to customer questions via telephone and written correspondence about insurance benefits, provider contracts, eligibility and claims.
• Analyzes problems and provides information and solutions.
• Documents inquiry outcomes for accurate tracking and analysis.

Skills

Communication

Spanish language

Problem solving

Interpersonal skills

Analytical skills

Education

High school diploma or equivalent

Job description

Position Information

Anticipated End Date: 2026-11-28

Position Title: Customer Care Representative I

Hybrid Work Arrangement

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. 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.

Job Overview

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.

Employment Details

Job Level: Non-Management Non-Exempt

Job Family: CUS > Care Reps

About Elevance Health

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.

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.

Based on a Hybrid Workforce Strategy, unless specifically noted 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.

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

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.

Please visit the Contract Worker Community Page.

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.