Representative, Customer Service I (REMOTE)

$35,984 - $37,440/Yr

Evolent Health - Oklahoma City, OK

Full-time - Entry Level

Remote - Oklahoma City, OK

Professional, Scientific, and Technical Services

About the position

The Customer Service Representative I position at Evolent Health is a remote role focused on providing exceptional support to health plan members and providers. The role emphasizes collaboration, continuous learning, and a customer-centric approach, aiming to improve health outcomes through effective communication and problem-solving. Representatives will manage inquiries related to health plan benefits, claims, and other healthcare procedures, ensuring a positive experience for customers.

Responsibilities

• Answer and manage inbound inquiries regarding health plan benefits and claims, eligibility, and other related topics.
• Conduct outbound and/or return calls to customers as necessary.
• Ask appropriate questions and listen actively to identify specific questions or issues.
• Document relevant information in a clear and concise manner in computer systems.
• Communicate and partner with customers tactfully and empathetically to resolve issues.
• Handle and process customer complaints/grievances while applying appropriate conflict management skills.
• Meet performance goals in efficiency, accuracy, quality, member satisfaction, and attendance.
• Read, comprehend, and verbalize processes and procedures of the organization and health insurance coverage.

Requirements

• At least 1 year of call center experience is required.
• Ability to handle a heavy call volume of 50-100 calls daily.
• Demonstrated ability in using computer and Windows PC applications, including strong keyboard and navigation skills.
• Ability to type 35 WPM and learn new computer programs.
• Ability to maintain strict confidentiality of protected health information.
• This is a work from home position requiring a quiet, private workspace and reliable internet connectivity.

Nice-to-haves

• Bilingual in Spanish & English is a plus.
• 2+ years at a health plan, TPA or related call center setting is a plus.
• Knowledge of managed care, Commercial, Marketplace, Medicaid and/or Medicare programs is a plus.

Benefits

• Comprehensive health insurance benefits
• Bonus component based on performance
• Work/life balance and flexibility
• Diversity and inclusion initiatives