Bilingual Representative, Customer Service I (REMOTE) - MD, VA, or DC CANDIDATES ONLY

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

What You’ll Be Doing:

*BILINGUAL Maryland, Virginia, or Washington, DC Candidates ONLY as this client has location specific requirements. *

Our customer service team offers candidates the opportunity to make a meaningful impact by providing exceptional support to our valued customers, fostering a sense of job satisfaction through problem-solving and positive interactions. Our team values collaboration, continuous learning, and a customer-centric approach, ensuring that every team member contributes to providing better health outcomes.

Collaboration Opportunities:

• Customer Service Representatives (CSR’s) will be working with and providing support to health plan members, providers and/or their representatives. Leadership rewards and recognizes CSR’s regularly for performance in an environment that challenges while providing clear direction and support to foster success in the role.

What You Will Be Doing:

• Answer and manage inbound inquiries regarding health plan benefits and claims, eligibility, medical and other healthcare procedures, billing and payments and other related topics from customers in a prompt, courteous manner. Conduct out-bound and/or return calls to customers as necessary.
• Ask appropriate questions and listen actively to identify specific questions or issues to provide appropriate response and type of assistance the customer needs while documenting relevant information in a clear and concise manner in computer systems.
• Communicate and partner with customers tactfully and empathetically to resolve issues, using clear language translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can comprehend and act upon.
• Handle and process customer complaints/ grievances while applying appropriate conflict management skills to de-escalate potentially stressful situations.
• Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction and attendance. Adhere to all applicable …