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Representative, Customer Service, Medicare Advantage

Evolent Health Chicago, IL
  • Posted: October 26, 2019
  • Full-Time

It's Time For A Change... Your Future Evolves Here
Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.
Are we growing? Absolutely about 40% in year-over-year revenue growth in 2018 . Are we recognized? Definitely. We have been named one of "Becker's 150 Great Places to Work in Healthcare" in 2016, 2017, 2018 and 2019, and One of the "50 Great Places to Work" in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you're looking for a place where your work can be personally and professionally rewarding, don't just join a company with a mission. Join a mission with a company behind it.
Evolent Health has MULTIPLE OPENINGS for Bilingual Customer Service Representatives who are energetic, eager individuals with outstanding customer service skills and knowledge of managed care processes, health insurance coverage and Medicare Advantage plans (preferred) to join our customer service team in our Chicago, IL office.
**Please apply if you are bilingual in English & Spanish. Only Spanish speaking candidates will be considered at this time.
We are seeking skilled and experienced call center individuals for our Medicare Advantage Customer Service Department. These team members are responsible for providing support to Medicare Advantage health plan members, providers and their representatives; serves as a resource person for staff and community medical personnel and responds to requests for managed care information for all product lines and subsidiaries in a fast-paced call center environment. The call center operates 7 days a week, 7 a.m. to 8 p.m.
What You'll Be Doing:

  • Respond to member/provider/agent/broker inquiries via telephone and other communication channels, regarding health insurance benefits, eligibility, contract interpretation, medical and other healthcare procedures, billing, subscriber problems, and denied services.
  • Handle all inquiries in a prompt, courteous manner.
  • Conduct out-bound and/or return calls to customers as necessary.
  • Analyze problems and provide accurate and complete information and solutions.
  • Deal tactfully and empathetically with customers.
  • Receive inquiries and complaints from customers regarding problem claims; route these issues to the appropriate person or department for a resolution,
  • Document all interactions in a clear and concise manner on the members account
  • Establish and maintain effective working relationships with physician office staff.
  • Read, comprehend and verbalize processes and procedures of the organization and of health insurance coverage.
  • Adhere to all applicable department, organization and/or regulatory policies and procedures.
  • Multi-task and pay close attention to detail.
  • Training Hours: 8:00 am - 5:00 pm CST
  • Hours of Operation: 7 days a week, 7:00 am - 8:00 pm (your shift will be determined after training)
  • Bilingual in Spanish & English REQUIRED
  • High school diploma or GED
  • 2 years call center, healthcare, or related field experience
  • Excellent data entry skills. Must be able to type 35 WPM
  • A positive and cheerful attitude that reflects favorable upon the organization's image.
  • An educative approach to answering questions and informing people of health plan policies, procedures, or decisions.
  • Strong active listening skills, confident responsiveness that maintains the organization's integrity.
  • The ability to handle sensitive situations and stress effectively
  • Exceptional customer service skills and ability to work independently.
  • Must be able to work weekends and evening shifts.
  • Must maintain an excellent attendance record.
  • Must possess excellent verbal and written communications skills.
  • Ability to multi-task and work in a team environment.
  • Must be detail-oriented and set high standards for accuracy.
  • Must have demonstrated experience with Microsoft Office Suite (Outlook, Word, Excel, Power Point, etc.)
  • Strong interpersonal, organizational, analytical, decision-making, and problem-solving skills required.
  • Ability to satisfactorily complete all company required, job-specific, and departmental training
  • Ability to maintain strict confidentiality of all employee and company information.
  • Bachelor's Degree or equivalent experience
  • 2 years Medicare Advantage customer service experience
  • Working knowledge of Medicare Advantage, medical terminology and HIPAA guidelines
  • 2 years call center experience
Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.
Evolent Health offers a great working environment and competitive benefit package. Candidates offered a position must be able to successfully pass a drug test and background check. * Skills testing may be required.

Evolent Health


Chicago, IL
60664 USA

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