Customer Care Representative I

About the Role

The Customer Care Representative I is responsible for successfully completing required basic training and performing basic job functions with assistance for non-basic issues.

Key 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.
• 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.
• Receives and places follow-up telephone calls/e-mails to answer routine customer questions.
• Uses computerized systems for tracking, information gathering, and troubleshooting.
• Multi-tasks, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
• Maintains focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment.
• Performs other duties as assigned.

Requirements & Tech Stack

• Must pass the appropriate pre-employment test battery.
• Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment.
• Strong verbal and written communication skills, both with virtual and in-person interactions.
• Attentive to details, a critical thinker, and a problem-solver.
• Demonstrates empathy and persistence to resolve caller issues completely.
• Comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
• Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.

Qualifications

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

Preferred Skills, Capabilities and Experiences

• Call center experience strongly preferred.
• Experience working in a healthcare environment strongly preferred.
• For URAC accredited areas, strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills are expected.

Location & Hours

• This role enables associates to work virtually full-time, except for required in-person training sessions.
• Alternate locations may be considered if candidates reside within a commuting distance from an office.
• 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.
• Assigned a shift between 9:30 AM and 8:00 PM Eastern time.