**Experienced Customer Service Representative – Medicare Appeal Process Support**

Remote, USA Full-time
Are you passionate about delivering exceptional customer experiences and making a meaningful impact in the healthcare industry? Do you thrive in a dynamic, fast-paced environment where no two days are ever the same? If so, we invite you to join our team of dedicated professionals at blithequark, a leading provider of innovative health solutions that empower better health outcomes through technology, services, and clinical expertise. As a Customer Service Representative at blithequark, you will play a vital role in supporting the Medicare Appeal process by providing top-notch customer service, resolving complex issues, and utilizing your working knowledge of our services to meet productivity and quality standards. If you're a motivated, customer-focused individual with a passion for delivering exceptional results, we encourage you to apply for this exciting opportunity. **About blithequark** At blithequark, we're committed to empowering better health outcomes through our innovative health solutions. Our mission is to innovate health solutions that deliver maximum value and impact, and we're dedicated to making this vision a reality through our people. We're a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. **Job Summary** The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints, and requests, adhering to internal policies and procedures, and utilizing working knowledge of the organization's services to meet productivity and quality standards. **Key Responsibilities** * Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational) * Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxes * Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times * Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures * Interacts with hospitals, physicians, beneficiaries, or other program recipients * Investigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate party * Meets or exceeds standards for call volume and service level per department guidelines * Initiates files by collecting and entering demographic, provider, and procedure information into the system * Serves as liaison between the Review Supervisors and external providers * Maintains logs and documents disposition of incoming and outgoing calls **Requirements** * High School diploma or equivalent * 2+ year's customer service/telephone experience in a similar call center environment and/or industry * Must have ability to effectively communicate with team members and external customers * Must have ability to research and resolve issues related to Medicaid program and service eligibility * Bilingual (Spanish/English) **Preferred Qualifications/Experience** * Previous experience in the medical office or other medical setting preferred * General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred) * Knowledge of CPT and HCPCS codes preferred * PC proficiency to include Microsoft Office Suite * Experience with Microsoft programs **Benefits** At blithequark, we're committed to providing our employees with a comprehensive benefits package that includes: * Comprehensive health plans * Paid time off * Retirement savings * Corporate wellness * Educational assistance * Corporate discounts * And more! **Compensation** The pay range for this position is $15.85 - $18.20. Based on our compensation program, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level. **Why Join Our Team?** At blithequark, we're passionate about delivering exceptional customer experiences and making a meaningful impact in the healthcare industry. We're a team of dedicated professionals who are committed to our mission and values, and we're looking for like-minded individuals to join our team. If you're a motivated, customer-focused individual with a passion for delivering exceptional results, we encourage you to apply for this exciting opportunity. **How to Apply** If you're interested in joining our team, please visit our website at blithequark.com/careers/ to apply for this position. We're an equal opportunity employer and welcome applications from diverse candidates. **Equal Opportunity Employer** blithequark is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. **Contact Us** If you have any questions or would like to learn more about this opportunity, please don't hesitate to contact us at [insert contact information]. We look forward to hearing from you! Apply for this job
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