Customer Care Representative I

About the role

This role enables associates to work virtually full-time, except for 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. 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.

The Customer Care Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery.

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.
• 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.
• Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
• Additional expectations to include but not limited to: 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, 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.
• Performs other duties as assigned.

Minimum 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.

Preferred Skills, Capabilities and Experiences

• Call center experience strongly preferred.
• Experience working in a healthcare or mental health environment strongly preferred.
• Strong computer proficiency with the ability to quickly learn and navigate new systems and applications.
• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Pay

For candidates working in person or virtually in New York, the salary for this specific position is $19.50/HR to $22.25/HR.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase and 401k contribution
• Merit increases
• Paid holidays and Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical, dental, and vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs and financial education resources

Schedule

This role enables associates to work virtually full-time, except for required in-person training sessions. Associates 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.