Customer Care Specialist - Call Center

Representative - Call Center

About Us 

Zelis is modernizing the healthcare financial experience in the United States (U.S.) across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.

Why We Do What We Do 

In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.

Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture. 

Position Overview

The primary role of the Customer Care Specialist is to serve as the liaison between Zelis, our members and providers. Individuals who succeed in this role will demonstrate excellent customer service skills, which include strong verbal and written communication skills. This position will be responsible for metrics such as average speed of answer, average hold time and average handle time; all in an effort to best service our callers. The individual will use problem-solving skills to resolve issues with diplomacy and accuracy.

What you will do:

• Answer incoming phone calls from healthcare providers, clients and members nationwide and identify the type of assistance the customer needs.

• Attempt first call resolution through provider education on both inbound and outbound calls.

• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems

• Attempt first call resolution through provider education, and by researching and exploring answers and alternative solutions; implementing solutions with leadership; escalating unresolved problems to the appropriate department.

• Required to meet specific call center performance metrics of productivity and quality assurance.

• Performs other job-related duties as required.

• Maintain awareness of and ensure adherence to Zelis standards regarding privacy.

• Ensure compliance with HIPAA regulations and requirements.

 

What you will bring:

Required

·       Bachelors degree or equivalent required.

·       2+ years of healthcare and medical claims processing experience within a provider or facility’s office or Payer preferred but not required.

• Excellent attention to detail.

·       Strong working knowledge of MS Suite (Word, Excel, Outlook), computer systems, applications and operating systems.

·       Strong time management and organizational skills to prioritize multiple tasks and complete work within deadlines.

• Excellent communication skills both verbal and written, to communicate ideas and information clearly.

• Self-motivation and the ability to work independently and as a team.

 

 

Work environment

• A standard work week exists but with the understanding that additional time/effort outside of the usual parameters can/will occur based upon the overall needs of the integration, where deadlines exist and when necessary, due to the needs of the integration team. 

• Ability to lift and move approximately thirty (30) pounds on a non-routine basis.

• Ability to sit for extended periods of time. 

• Working as per EST time

• Working from office

 

Disclaimer:

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.

 

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.

Commitment to Diversity, Equity, Inclusion, and Belonging

At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity

Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability and require reasonable accommodation with any part of the application and/or interview process, please email talentacquisition@zelis.com.

Experience Level

Entry Level