Representative, Customer Service I (MUST RESIDE IN NY – FULLY REMOTE) in Columbus, Ohio

Evolent Health

Your Future Evolves Right here

Evolent Well being has a daring mission to vary 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. By way of 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. Should you’re on the lookout for a spot the place your work could be personally and professionally rewarding, don’t simply be part of an organization with a mission. Be a part of a mission with an organization behind it.

Why We’re Well worth the Software:

  • We proceed to develop 12 months over 12 months.

  • Acknowledged as a frontrunner in driving vital 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 the perfect 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 gives candidates the chance to make a significant impression by offering distinctive help to our valued prospects, fostering a way of job satisfaction via 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 often for efficiency in an surroundings that challenges whereas offering clear path and help to foster success within the function.

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 prospects in a immediate, courteous method. Conduct out-bound and/or return calls to prospects as mandatory.

  • Ask acceptable questions and hear actively to determine particular questions or points to supply acceptable response and sort of help the client wants whereas documenting related data in a transparent and concise method in laptop programs.

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

  • Deal with and course of buyer complaints/ grievances whereas making use of acceptable battle administration expertise to de-escalate probably aggravating 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 health insurance protection.

  • Coaching features a digital classroom surroundings 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 exhibit proficiency of the fabric on the finish of coaching.

  • Hours of Operation: 6 days per week, 8:00am – 9:00pm ET (hours depend 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 popular:

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

• 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 means in utilizing laptop and Home windows PC functions, which incorporates sturdy keyboard and navigation expertise, means to kind 35 WPM and be taught new laptop applications – Required

• Means to work often 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 means to take an educative method, hear skillfully, accumulate related data, decide rapid requests and determine the present and future wants of the client, 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

• This can be a do business from home place, which requires a quiet, non-public workspace with out noise and distractions, and dependable web connectivity offered via a wired reference to a minimal of 100 MBPS pace. A cellular, scorching spot, or WiFi connection is NOT acceptable – Required

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

• Data of managed care, Industrial, Market, Medicaid and/or Medicare applications; data of medical coverage advantages and exclusions – Most popular

Technical Necessities:

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

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 talent set required for the place and commensurate with expertise and will range above and beneath the acknowledged quantities.

Do not see the dream job you might be on the lookout for? Drop off your contact data and resume and we are going to 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 monitor our recruitment effort, please point out in your cowl/motivation letter the place ( you noticed this posting.

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