Customer Care Representative III

Elevance Health; Roanoke (VA); Remote; USD 35,000 - 55,000; Full time

Job summary

An established industry player is seeking a Customer Care Representative III to enhance customer experiences and streamline claims processes. This role is pivotal in resolving inquiries and ensuring timely communication with customers, group administrators, and providers. The ideal candidate will possess a strong background in claims adjudication and customer service, demonstrating proficiency in various contact systems. Join a Fortune 25 company dedicated to improving lives and communities, where your contributions will make a significant impact. Elevance Health fosters a culture of growth, offering competitive rewards and benefits to support your professional journey.

Benefits

Paid Time Off

401(k) + match

Incentive bonus programs

Medical benefits

Dental benefits

Vision benefits

Life insurance

Wellness programs

Financial education resources

Qualifications

• 2+ years of experience in claims and customer contact environment.
• Extensive knowledge of company services and insurance benefits.

Responsibilities

• Resolve and respond to inquiries from customers and providers.
• Perform in-depth research for timely issue resolution.
• Identify process improvement opportunities.

Skills

Claims adjudication

Customer service

Problem-solving

Communication

Education

High School Diploma or equivalent

Tools

Claims systems

Contact and inquiry systems

Job description

Title: Customer Care Representative III

Location: This position will work a virtual model. Ideal candidates will live within 50 miles of 602 S Jefferson St Roanoke, VA 24011.

The Customer Care Representative III is responsible for having extensive knowledge of company services, products, insurance and dental benefits, provider contracts and claims. Functions in a multi-functional capacity and is proficient in the use of all applicable claims systems, demonstrating the ability to adjudicate a variety of claims. Resolves and documents contacts with constituents, demonstrating contact expertise. Uses all applicable contact and inquiry systems proficiently.

How you will make an impact:

• Resolves and responds to questions from customers, group administrators, providers, and brokers via claims adjudication, telephone and written communications.
• Applies knowledge to administer benefits and respond to inquiries.
• Interacts with other areas as necessary to resolve issues.
• Performs in-depth research to resolve inquiries for customers through direct coordination with providers, group administrators and internal departments.
• Initiates, monitors and provides follow-up to ensure timely resolution and closure to issues.
• Proactively takes necessary actions to prevent future problems from occurring.
• Recognizes system, process and workflow opportunities and offers alternatives for improvement.

Minimum Requirements:

• HS diploma or equivalent and a minimum of 2 years experience with the company in combination of claims and customer contact automated environment (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background.

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.

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.