Representative, Customer Service I (MUST RESIDE IN NY – FULLY REMOTE) in Austin, Texas

Evolent Health

Your Future Evolves Right here

Evolent Well being has a daring mission to alter the well being of the nation by altering the way in which well being care is delivered. Evolenteers make a distinction wherever they’re, whether or not it’s at a medical heart, within the workplace, or whereas working from house throughout 48 states. We empower you to work from the place you’re employed finest, which makes juggling careers, households, and social lives a lot simpler. Via our recognition applications, we additionally spotlight staff who stay our values, give again to our communities annually, and are champions for bringing their entire selves to work every day. For those who’re on the lookout for a spot the place your work could be personally and professionally rewarding, don’t simply be a part of an organization with a mission. Be part of a mission with an organization behind it.

Why We’re Well worth the Utility:

  • We proceed to develop 12 months over 12 months.

  • Acknowledged as a frontrunner in driving necessary range, fairness, and inclusion (DE&I) efforts ( .

  • Achieved a 100% rating two years in a row on the Human Rights Marketing campaign’s Company Equality Index ( recognizing us as a finest place to work for LGBTQ+ equality.

  • Named to’s record of one of the best firms for ladies to advance for 3 years in a row ( (2020, 2021 and 2022).

  • Proceed to prioritize the worker expertise and achieved a 90% total engagement rating on our worker survey in Could 2022.

  • Publish an annual DE&I report ( to share our progress on how we’re constructing an equitable office.

What You’ll Be Doing:

Our customer support group provides candidates the chance to make a significant impression by offering distinctive help to our valued clients, fostering a way of job satisfaction by problem-solving and optimistic interactions. Our group values collaboration, steady studying, and a customer-centric method, guaranteeing that each group member contributes to offering higher well being outcomes.

Collaboration Alternatives:

  • Buyer Service Representatives (CSR’s) can be working with and offering help to well being plan members, suppliers and/or their representatives. Management rewards and acknowledges CSR’s recurrently for efficiency in an atmosphere that challenges whereas offering clear route and help to foster success within the position.

What You Will Be Doing:

  • Reply and handle inbound inquiries concerning well being plan advantages and claims, eligibility, medical and different healthcare procedures, billing and funds and different associated subjects from clients in a immediate, courteous method. Conduct out-bound and/or return calls to clients as needed.

  • Ask applicable questions and pay attention actively to determine particular questions or points to supply applicable response and kind of help the shopper wants whereas documenting related data in a transparent and concise method in pc programs.

  • Talk and companion with clients tactfully and empathetically to resolve points, utilizing clear language translating healthcare-related jargon and sophisticated processes into easy, step-by-step directions clients can comprehend and act upon.

  • Deal with and course of buyer complaints/ grievances whereas making use of applicable battle administration abilities to de-escalate doubtlessly hectic conditions.

  • Meet the efficiency objectives established for the place within the areas of effectivity, accuracy, high quality, member satisfaction and attendance. Adhere to all relevant division, group and/or regulatory insurance policies and procedures.

  • Learn, comprehend, and verbalize processes and procedures of the group and of medical insurance protection.

  • Coaching features a digital classroom atmosphere with trainers who’ve expertise working throughout the Evolent Buyer Service Operations (CSO) name heart. Coaching Hours are 8:00am – 4:30pm CT Monday–Friday (for roughly 6-weeks). Trainees can be required to attend everything of coaching, efficiently full the required coaching schedule, and reveal proficiency of the fabric on the finish of coaching.

  • Hours of Operation: 6 days per week, 8:00am – 9:00pm ET (hours rely upon the shopper to which you might be assigned, and your shift can be decided throughout coaching if not earlier than).

{Qualifications} Required and Most well-liked:

• Bilingual in Spanish & English (validated by way of bilingual evaluation upon provide acceptance) – Most well-liked

• Highschool diploma or GED – Required

• Not less than 1 12 months name heart expertise – Required

• Means to deal with a heavy name quantity of 50-100 calls day by day – Required

• Demonstrated skill in utilizing pc and Home windows PC purposes, which incorporates robust keyboard and navigation abilities, skill to kind 35 WPM and be taught new pc applications – Required

• Means to work recurrently scheduled shifts inside hours of operation together with the coaching interval, the place lunches and breaks are scheduled, with the flexibleness to regulate day by day schedule, and work over-time and/or weekends, as wanted – Required

• Demonstrated skill to take an educative method, pay attention skillfully, gather related data, decide instant requests and determine the present and future wants of the shopper, answering questions and informing of well being plan insurance policies, procedures, or selections – Required

• Means to take care of strict confidentiality of protected well being data – Required

• It is a earn a living from home place, which requires a quiet, personal workspace with out noise and distractions, and dependable web connectivity offered by a wired reference to a minimal of 100 MBPS velocity. A cell, sizzling spot, or WiFi connection is NOT acceptable – Required

• 2+ years at a well being plan, TPA or associated name heart setting – Most well-liked

• Information of managed care, Industrial, Market, Medicaid and/or Medicare applications; data of medical coverage advantages and exclusions – Most well-liked

Technical Necessities:

We require that every one staff have the next technical functionality at their house: Excessive velocity web over 10 Mbps and, particularly for all name heart staff, the flexibility to plug in on to the house web router. These at-home technical necessities are topic to alter with any scheduled re-opening of our workplace places.

Evolent Well being is an equal alternative employer and considers all certified candidates equally with out regard to race, coloration, faith, intercourse, sexual orientation, gender identification, nationwide origin, veteran standing, or incapacity standing.

Compensation Vary: The minimal wage for this place is $17.50-18.50, plus advantages. Salaries are decided by the ability set required for the place and commensurate with expertise and will differ above and beneath the said quantities.

Do not see the dream job you might be on the lookout for? Drop off your contact data and resume and we’ll attain out to you if we discover the right match!

For extra insights about Evolent Well being, click on on Life At Evolent ( to be taught extra!

To assist us observe our recruitment effort, please point out in your cowl/motivation letter the place ( you noticed this posting.

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