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Customer Care Specialist

Sapphire Digital

Sapphire Digital

Customer Service
Atlanta, GA, USA
Posted on Thursday, June 27, 2024

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. Other requirements involve the delivery of prompt, accurate, and cost-effective service for clients, and to meet or exceed company and client expectations for service. The individual will use problem-solving skills to resolve issues with diplomacy and accuracy.

Key Responsibilities:

  • 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.

Professional Experience:

  • 2+ years of experience within healthcare industry, preferable in a call center environment.
  • Outstanding written & verbal communication skills
  • Knowledge of MS Outlook, MS Word, MS Excel & Internet Explorer
  • Strong prioritizing & organizational skills
  • Excellent customer service & telephone skills


  • High School Diploma/GED required

Work Environment:

  • Travel requirements to (primarily) domestic destinations should not exceed 5%.
  • 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.
  • A standard business environment exists with moderate noise levels.
  • Ability to type on a keyboard
  • Ability to lift and move approximately thirty (30) pounds on a non-routine basis.
  • Ability to sit for extended periods of time.

Location and Workplace Flexibility:

We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.

As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

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 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.

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

Accessibility Support

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

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.