Customer Care Representative III

Location : This role enables associates to work virtually full-time, with the exception of 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.

Work Hours : Monday - Friday 8am - 5pm or 9am - 6pm CST

The Customer Care Representative III is responsible for reviewing requests by mail, telephone, or in person regarding insurance claims/policies. Fully proficient in all key areas; performs many complex functions.

How you will make an impact :

• Provider Relationship Management: Builds and maintains strong professional relationships with providers, determine provider needs and effectively communicates solutions.
• Provider Education: Conduct outreach to educate providers on payment integrity processes and supports chart retrieval efforts among other general inquiries
• Technical Support & PHI Management: Skilled handling of PHI, ensuring compliance with all regulations and standards, while being attentive to internal and external inquiries, incumbent will provide attentive support for internal and external parties and be skilled in critical thinking and creative solutions.
• Operational Analysis: Research and analyze data to address operational challenges and customer service issues, while maintaining high standards of PHI handling.
• Communication Resolution: Address and resolve communication issues or variances maintaining high levels of confidentiality and compliance. 
• Interdepartmental Coordination: Facilitate interdepartmental communications and interactions between internal and external parties focusing of provider needs to determine optimal means of project completion within correspondence applications. 
• Analysis: Analyzes complex end user needs to determine optimal means of project completion within general correspondence applications. 
• Vendor Management: Support Release of Information vendor relationships and act as liaison between stakeholders to keep informed of issues with providers/vendors.
• Provider Escalations: Assists with inquires related to provider escalations, while consistently acting as the front line for general provider inquiries. 
• Provider Outreach: Dedicate approximately 50% of the workday conducting provider outreach and educational sessions. 
• Data Integrity: Ensure accurate provider information, building provider rapport and maintaining provider information such as demographics, contact details, across multiple systems in a fast-paced environment. 
• May support other program initiatives or ad-hoc projects as deemed.

Minimum Requirements :

• Requires a HS diploma or equivalent and a minimum of 3 years of the company's experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.  

Preferred Skills, Capabilities and Qualifications:

• Expertise in Medical Records & Release of Information.
• Accounts Receivables and/or Collections experience preferred.
• Call center customer service experience preferred. 
• Natural problem solving and technical skills.
• Ability to modernize existing processes
• Intermediate computer skills including window-based applications (Word, PowerPoint, Excel, & Access).
• 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 location(s), the salary* range for this specific position is $21.45 to $32.19/hr.

Location:  Illinois

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 considered to be 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 Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
 

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 elevancehealthjobssupport@elevancehealth.com 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.